Medications which are commonly used to treat Anxiety Disorders

*Disclaimer*
This section is not intended as professional medical advice and is meant to be used only as a guide and general overview of some commonly used medications in the treatment of anxiety disorders.
You should always check with your doctor prior to starting any new medication. The use of medications should always be done under professional medical supervision.


Medication interaction checker
http://reference.medscape.com/drug-interactionchecker

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*SSRIs*

-The SSRI (Selective Serotonin Re-uptake Inhibitors) class are among some of the most common medications used to treat anxiety disorders today.
-They are considered 'first line agents' which means that they are usually the first type of medication that a doctor will try if a patient has anxiety.

SSRIs include:

*Paxil (generic name; Paroxetine hydrochloride)
-Common brand names: Paxil, Paxil CR, Seroxat, Aropax, Pondera, Deroxat, Paroxat, Cebrilin
-More information can be found at; http://www.drugs.com/paxil.html
- Paxil is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major depressive disorder
  • Obsessive compulsive disorder
  • Panic disorder
  • Social anxiety disorder
  • Generalized anxiety disorder
  • Posttraumatic stress disorder
  • Premenstrual dysphoric disorder


*Lexapro (generic name; Escitalopram oxalate)
- Common brand names: Lexapro, Lexaprin, Cipralex, Sipralexa, Seroplex
-More information can be found at; http://www.drugs.com/lexapro.html
- Lexapro is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major Depressive Disorder
  • Generalized Anxiety Disorder
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • obsessive-compulsive disorder
  • panic disorder
  • social anxiety disorder
  • posttraumatic stress disorder


*Zoloft (generic name; Sertraline hydrochloride)
-Common brand names: Zoloft, Lustral, Sertranex, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz
-More information can be found at; http://www.drugs.com/zoloft.html
- Zoloft is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major Depressive Disorder
  • Obsessive-Compulsive Disorder
  • Panic Disorder
  • Posttraumatic Stress Disorder (PTSD)
  • Premenstrual Dysphoric Disorder (PMDD)
  • Social Phobia (social anxiety)
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • general anxiety disorder
  • bulimia nervosa
  • binge eating disorder (BED)


*Celexa (generic name; Citalopram hydrobromide)
-Common brand names: Celexa, Cipramil, Sipralexa, Seropram, Celepram
-More information can be found at; http://www.drugs.com/celexa.html
- Celexa is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major depressive disorder
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • social anxiety disorder (social phobias)
  • anorexia nervosa
  • binge-eating disorder
  • bulimia nervosa
  • obsessive-compulsive disorder (OCD)


*Prozac (generic name; Fluoxetine hydrochloride)
-Common brand names: Prozac, Sarafem, Fontex, Foxetin, Ladose, Fluctin, Prodep, Fludac, Lovan
-More information can be found at; http://www.drugs.com/prozac.html
- Prozac is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major depressive disorder
  • Obsessive-compulsive disorder
  • Bulimia nervosa (binge-eating and vomiting behaviors in patients with moderate to severe bulimia nervosa)
  • Panic disorder


*Luvox (generic name; (Fluvoxamine Maleate)
- Common brand names: Luvox, Luvox CR, Faverin, Movox
-More information can be found at; http://www.drugs.com/mtm/luvox.html
-Luvox is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Obsessive-Compulsive Disorder
  • Social Anxiety Disorder (social phobias) (Luvox CR formulation only)
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Major depressive disorder
  • Posttraumatic Stress Disorder (PTSD)
  • Panic disorder


*Viibryd (generic name; (Vilazodone)
- Common brand names: Viibryd
-More information can be found at; http://www.drugs.com/viibryd.html
-Viibryd is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major depressive disorder
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Anxiety Disorders
  • Obsessive compulsive disorder (OCD)


-Notes and precautions;
-The SSRIs should never be combined with MAOIs (Monoamine oxidase inhibitors) as this combination can cause Serotonin Syndrome, a serious medical emergency .
-A Doctor should monitor for the activation of bipolar disorder and suicidal ideation during the beginning of treatment

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*SNRIs*

-The SNRI (Selective Serotonin-Norepinephrine Re-uptake Inhibitors) class are among some of the most common medications used to treat anxiety disorders today.
-They are considered 'first line agents' which means that they are usually the first type of medication that a doctor will try if a patient has anxiety.

*Effexor XR (generic name; Venlafaxine hydrochloride)
-Common brand names: Effexor, Effexor XR
-More information can be found at; http://www.drugs.com/mtm/effexor-xr.html
-Effexor XR is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major depressive disorder
  • Generalized anxiety disorder (GAD)
  • Social anxiety disorder
  • Panic disorder
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • post-traumatic stress disorder (PTSD)
  • fibromyalgia
  • chronic pain syndromes
  • attention-deficit hyperactivity disorder (ADD/ADHD)


*Cymbalta (generic name; Duloxetine hydrochloride)
- Common brand names: Cymbalta, Xeristar, Yentreve
-More information can be found at; http://www.drugs.com/cymbalta.html
- Cymbalta is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major depressive disorder
  • Generalized anxiety disorder
  • Fibromyalgia
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Social anxiety disorder
  • Panic disorder
  • post-traumatic stress disorder (PTSD)


*Pristiq (generic name; Desvenlafaxine Succinate)
- Common brand names: Pristiq
-More information can be found at; http://www.drugs.com/pristiq.html
- Pristiq is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major depressive disorder
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Fibromyalgia
  • Generalized anxiety disorder (GAD)
  • Social anxiety disorder (social phobia)
  • Panic disorder
  • Posttraumatic stress disorder (PTSD)


-Notes and precautions;
-The SNRIs should never be combined with MAOIs (Monoamine oxidase inhibitors) as this combination can cause Serotonin Syndrome and Hypertensive Crisis, a serious medical emergency.
-A Doctor should monitor for the activation of bipolar disorder and suicidal ideation during the beginning of treatment
-Blood Pressure should be monitored regularly during treatment especially in those prone to high blood pressure.
-Care should be taken when withdrawing from an SNRI as suddenly stopping them may produce a Withdrawal Syndrome, it is recommended to taper off slowly over a period of weeks or months.
-Cymbalta should not be used in those who have pre-existing liver damage.

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*Benzodiazepines*

-Benzodiazepines as a class are useful in the treatment of anxiety disorders, insomnia, agitation, seizures, muscle spasms and alcohol withdrawal.
-They are generally prescribed for short term or occasional use (generally taken before or during a period of acute anxiety) in the treatment anxiety disorders, but may be used long term in certain cases
-Xanax (alprazolam) is the most commonly prescribed psychoactive medicine (medicines which work in the mind) prescribed in the USA

*Xanax (generic name; Alprazolam)
-Common brand names: Xanax, Xanax XR, Niravam
-More information can be found at; http://www.drugs.com/xanax.html
- Xanax is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Generalized anxiety disorder
  • Panic disorder
  • Other anxiety disorders
  • Anxiety associated with depression
  • Premenstrual dysphoric disorder
  • Irritable bowel syndrome and other somatic symptoms associated with anxiety disorders
  • Insomnia


*Klonopin (generic name; Clonazepam)
-Common brand names: Klonopin, Rivotril
-More information can be found at; http://www.drugs.com/klonopin.html
- Klonopin is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Panic disorder, with or without agoraphobia
  • Seizure Disorders
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Generalized anxiety disorder (GAD)
  • Social anxiety disorder (social phobia)


*Ativan (generic name; Lorazepam)
- Common brand names: Ativan, Temesta
-More information can be found at; http://www.drugs.com/ativan.html
- Ativan is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Acute Anxiety disorders
  • Anxiety associated with depressive symptoms (oral)
  • Initial treatment of status epilepticus (injection)
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Social Anxiety Disorder
  • Insomnia
  • Muscle spasms
  • Alcohol withdrawal
  • Panic disorder


*Valium (generic name; Diazepam)
- Common brand names: Valium, Antenex, Diastat
-More information can be found at; http://www.drugs.com/valium.html
- Valium is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Anxiety disorder
  • Symptoms of anxiety (short-term)
  • Acute alcohol withdrawal
  • Skeletal muscle spasm due to reflex spasms
  • Spasticity caused by upper motor neuron disorder
  • Convulsive disorder (adjunctive)
  • Pre-operative anxiety (injection only)
  • Initial treatment of status epilepticus (injection only)
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Insomnia
  • Panic Disorder
  • withdrawal from other benzodiazepines


-Notes and precautions;
-Benzodiazepines are associated with the development of physiological tolerance and dependance when used on a daily basis over prolonged periods time. If stopped abruptly acute withdrawal symptoms may be serious and as such a gradual taper plan should be implemented by your doctor when withdrawing from the long term daily use of a benzodiazapine to ensure safety.
-Benzodiazepines may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. They may add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system and may cause drowsiness. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; antipsychotics, sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates or medicine for seizures; muscle relaxants; or anesthetics.

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*Beta Blockers*

-Beta Blockers are used for a wide variety of medical purposes including most commonly the treatment of high blood pressure, irregular heartbeat, essential tremor and various cardiovascular disorders.
-Beta blockers, particularly Propranolol are also used 'off-label' in the acute treatment of Social Anxiety Disorder, they are especially useful in controlling the 'physical' effects of social anxiety such as racing heart, stuttering, hand tremor and blushing.

*Inderal (generic name; Propranolol)
- Common brand names: Inderal, Inderal LA, Avlocardyl, Deralin, Dociton, Inderalici, InnoPran XL, Sumial, Anaprilinum, Bedranol SR
- More information can be found at; http://www.drugs.com/inderal.html
-Inderal is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • tremors,
  • angina (chest pain),
  • hypertension (high blood pressure),
  • heart rhythm disorders,
  • other heart or circulatory conditions
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Social Anxiety Disorder (Acute symptoms)
  • Migraine Headache


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*Miscellaneous Anti-Anxiety Treatments *

*BuSpar (generic name; Buspirone)
- Common brand names: BuSpar
- More information can be found at; http://www.drugs.com/buspar.html
-BuSpar is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Management of anxiety disorders
  • Short-term treatment of symptoms of anxiety
  • Add-on Treatment in Major Depression


*Neurontin (generic name; Gabapentin)
- Common brand names: Neurontin
- More information can be found at; http://www.drugs.com/neurontin.html
-Neurontin is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Partial seizures with or without secondary generalization (adjunctive)
  • Postherpetic neuralgia
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Neuropathic pain/chronic pain
  • Anxiety Disorders


*Lyrica (generic name; Pregabalin)
- Common brand names: Lyrica
- More information can be found at; http://www.drugs.com/lyrica.html
-Lyrica is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Diabetic peripheral neuropathy
  • Postherpetic neuralgia
  • Fibromyalgia
  • Partial seizures in adults (adjunctive)
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Generalized anxiety disorder (Formally approved for this use in the European Union and Russia)
  • Panic disorder
  • Social anxiety disorder


*Vistaril (generic name; Hydroxyzine)
- Common brand names: Vistaril, Atarax, Marax
- More information can be found at; http://www.drugs.com/vistaril.html
-Vistaril is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Anxiety
  • Pruritus (itching) due to allergic conditions
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Insomnia


-Notes and precautions;
-The following medications may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. They may add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system and may cause drowsiness. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; antipsychotics, sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates or medicine for seizures; muscle relaxants; or anesthetics.

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*Miscellaneous Antidepressants *

*Remeron (generic name; Mirtazapine)
- Common brand names: Remeron, Avanza, Zispin
- More information can be found at; http://www.drugs.com/remeron.html
-Remeron is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Major depressive disorder
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Panic disorder
  • Generalized anxiety disorder
  • Posttraumatic stress disorder


*Desyrel (generic name; Trazodone)
- Common brand names: Desyrel, Oleptro
- More information can be found at; http://www.drugs.com/mtm/desyrel.html
-Desyrel is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Depression
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Anxiety
  • Insomnia


-Notes and precautions;
-The following medications may be associated with drowsiness, it is not advised to operate a motor vehicle, If you are starting one of these medications, it is important to avoid activities that require alertness, such as driving, until you find out how the medication affects you. They may add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system and may cause drowsiness. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; antipsychotics, sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates or medicine for seizures; muscle relaxants; or anesthetics.
-A Doctor should monitor for the activation of bipolar disorder and suicidal ideation during the beginning of treatment

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*Antihypertensive Agents*

*Catapres (generic name; Clonidine)
- Common brand names: Catapres, Kapvay
- More information can be found at; http://www.drugs.com/catapres.html
-Catapres is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Hypertension
  • Attention deficit hyperactivity disorder (ADHD)
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Tourette’s syndrome
  • Anxiety disorders, including Posttraumatic stress disorder (PTSD) and social anxiety disorder


*Tenex (generic name; Guanfacine)
- Common brand names: Intuniv, Tenex
- More information can be found at; http://www.drugs.com/mtm/tenex.html
-Tenex is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Hypertension
  • Attention deficit hyperactivity disorder (ADHD)
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Motor Tics and Tourette's syndrome
  • Anxiety disorders
  • Conduct Disorders


-Notes and precautions;
-The following medications may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. They may add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system and may cause drowsiness. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; antipsychotics, sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates or medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics.
-They may lower blood pressure so caution is advised for people suffering from Hypotension (low blood pressure). If suddenly withdrawn after periods of extended daily use Rebound hypertension (high blood pressure) may occur, as such they should generally be gradually tapered off when discontinuing therapy to avoid rebound effects from occurring.

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*MAOIs *

-MAOIs (Monoamine oxidase inhibitors) are a class of antidepressant which are generally considered to be highly effective for treatment resistant cases of depression and anxiety.
-They are generally not used as first line agents due to the need for an adherence to a strict diet and the avoidance of certain other medications due to potentially severe food and drug interactions

*Nardil (generic name; Phenelzine)
- Common brand names: Nardil
- More information can be found at; http://www.drugs.com/mtm/nardil.html
-Nardil is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Treatment-resistant depression
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Treatment-resistant panic disorder
  • Treatment-resistant social anxiety disorder


*Parnate (generic name; Tranylcypromine)
- Common brand names: Parnate
- More information can be found at; http://www.drugs.com/mtm/parnate.html
-Parnate is Approved by the US FDA (Food and Drug Administration) to treat the following disorders;
  • Treatment-resistant depression
In addition it is commonly used 'off-label' (which means that it is not formally approved by the US FDA but has shown good anecdotal efficacy in treating the disorder) for the following disorders;
  • Treatment-resistant panic disorder
  • Treatment-resistant social anxiety disorder


-Notes and precautions;
-Due to a large number of potentially fatal food and drug interactions MAOI users must adhere to a strict low tyramine diet as well as abstaining from many medications and recreational drugs.
-Serious and potentially fatal adverse reactions may occur with concurrent use of other antidepressants including SSRIs, SNRIs and TCAs, as well as other medications such as amphetamine (Adderall, Dexedrine), methylphenidate (Ritalin, Concerta), Pseudoephedrine, Dextromethorphan, which is found in many brands of over-the-counter cough syrup, and certain opioid painkillers including Tramadol (Tramal andUltram), and Pethidine/Meperidine (Demerol).
-Potentially fatal reactions can occur with recreational drugs such as methamphetamine, Cocaine and MDMA (Ecstasy), the AIDS drug ritonavir (Norvir), and high amounts of certain food products containing tyramine such as cheese, aged meats, soy products, beer and wine.

-An extensive list of foods which must be avoided when taking an MAOI can be found here; http://www.upmc.com/patients-visitor...iet-facts.aspx
-More information on medications which must be avoided when taking an MAOI can be found here; http://www.psychotropical.com/index.php/introduction

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