What Medicine Is Recommended For Anxiety

A generalized anxiety disorder can determine life and accompany many people over a longer period of time. There are, however, different methods with which one can learn to control anxiety and lead a normal life again. Certain medications can also help.

People with a generalized anxiety disorder (GAS) are not afraid of certain things or situations, but are afraid of all sorts of things. This is why we speak of “generalized” anxiety. It is psychologically very stressful and also causes various physical symptoms such as drowsiness, muscle tension or tachycardia. Being constantly afraid is very exhausting. However, there are various treatments that can reduce anxiety to a tolerable level.

In contrast to other anxiety disorders, the generalized anxiety disorder often only occurs in middle adulthood. In principle, however, an anxiety disorder can occur at any age.

Many people with a generalised anxiety disorder do not have the idea of going to a doctor. They try to get their fears under control themselves, for example with the help of books and information from the Internet. Some learn relaxation techniques such as progressive muscle relaxation, autogenic training or yoga. The effectiveness of such methods for self-management of anxiety disorders has not been well studied in studies. Relaxation techniques are often used as part of psychotherapy. However, how useful they are when used without other aids is not yet known.

Some people use herbal sedatives such as valerian, lavender or passion flower leaves. These drugs, too, have hardly been studied so far. Many people assume that herbal medicines are better tolerated and safer than other medicines. However, they can have side effects and partly influence the effect of other drugs.

Cognitive Behavioural Therapy

KVT does not only have a beneficial effect on anxiety. It can also relieve other symptoms such as depression, which can be associated with an anxiety disorder. Since the therapy requires a direct confrontation with one’s own fears, however, the treatment itself can sometimes be stressful. In general, the adverse effects of psychotherapy have not yet been well studied.

The aim of the cognitive approach is to change anxiety-triggering thought patterns by learning,

  • to recognize and question unrealistic fears and worries,
  • assess the actual probabilities and consequences of anxiety triggers and
  • to deal with uncertainty.

An example of frightening thought patterns are “catastrophic” thoughts, such as: immediately drawing extreme, exaggerated conclusions about the extent of the supposedly imminent disaster as soon as something disturbing happens. If such thoughts are recognized with the help of the therapist, one works on dismantling them or better dealing with them. In this way, KVT ultimately helps to think more clearly and to better control one’s own thoughts.

The second part of the therapy is about gradually reducing anxiety in certain situations and changing behaviour. In doing so, one confronts the fear in order to gradually overcome it. For example, a working mother who constantly calls kindergarten to make sure her child is well could gradually reduce the number of calls she receives. To facilitate such behavioural changes, therapy also teaches what can help to keep calm – for example, breathing exercises or relaxation techniques.

There are, however, different methods with which one can learn to control anxiety and lead a normal life again. Certain medications can also help.

People with a generalized anxiety disorder (GAS) are not afraid of certain things or situations, but are afraid of all sorts of things. This is why we speak of “generalized” anxiety. It is psychologically very stressful and also causes various physical symptoms such as drowsiness, muscle tension or tachycardia. Being constantly afraid is very exhausting. However, there are various treatments that can reduce anxiety to a tolerable level.

In contrast to other anxiety disorders, the generalized anxiety disorder often only occurs in middle adulthood. In principle, however, an anxiety disorder can occur at any age.

What can you do for yourself?

Many people with a generalised anxiety disorder do not have the idea of going to a doctor. They try to get their fears under control themselves, for example with the help of books and information from the Internet. Some learn relaxation techniques such as progressive muscle relaxation, autogenic training or yoga. The effectiveness of such methods for self-management of anxiety disorders has not been well studied in studies. Relaxation techniques are often used as part of psychotherapy. However, how useful they are when used without other aids is not yet known.

Some people use herbal sedatives such as valerian, lavender or passion flower leaves. These drugs, too, have hardly been studied so far. Many people assume that herbal medicines are better tolerated and safer than other medicines. However, they can have side effects and partly influence the effect of other drugs.

Self-treatment can mean that it takes a very long time to seek professional help. If an anxiety disorder severely restricts everyday life, certain psychotherapies and medications can help.

What happens during psychotherapy?

There are various psychotherapeutic procedures for treating a generalized anxiety disorder. The best studied and most effective is cognitive behavioural therapy (KVT).

An example of frightening thought patterns are “catastrophic” thoughts, such as: immediately drawing extreme, exaggerated conclusions about the extent of the supposedly imminent disaster as soon as something disturbing happens. If such thoughts are recognized with the help of the therapist, one works on dismantling them or better dealing with them. In this way, KVT ultimately helps to think more clearly and to better control one’s own thoughts.

The second part of the therapy is about gradually reducing anxiety in certain situations and changing behaviour. In doing so, one confronts the fear in order to gradually overcome it. For example, a working mother who constantly calls kindergarten to make sure her child is well could gradually reduce the number of calls she receives. To facilitate such behavioural changes, therapy also teaches what can help to keep calm – for example, breathing exercises or relaxation techniques.

What are the available drug treatments?

Various medications are available to treat a generalized anxiety disorder. Selective serotonin reuptake inhibitors (SSRIs) are often used.

Selective serotonin reuptake inhibitors

These drugs belong to the group of antidepressants. They can alleviate anxiety symptoms and help with the depressive symptoms that many people also experience.

If the treatment with SSRI has improved, it is recommended to continue taking the medication for another 6 to 12 months and then slowly reduce the dose. Studies suggest that the risk of relapse is lower. However, some people find it difficult to take the medication permanently. One reason may be side effects, another may be that if you feel better, you tend to stop taking it quickly.

Possible side effects of SSRI include nausea, insomnia, and sexual problems. For example, some people have less desire to have sex or do not have an orgasm. In men, ejaculation may be weaker or not at all. However, most people do not experience any side effects.

If you suffer from insomnia or nausea, it can be difficult to tell whether the medication is actually the cause. This is because these complaints are generally quite common. The body often gets used to the active substances. Side effects usually only occur in the first few weeks of use. It can therefore be worth waiting and not stopping the treatment immediately if a side effect becomes noticeable.

Other medications

There are a number of other drugs that can be used to treat a generalized anxiety disorder. However, many are usually only considered if treatment with SSRI has not been successful or is not possible for certain reasons:

selective noradrenalin reuptake inhibitors (SNRI): These include the active substances duloxetine and venlafaxine. They have a similar effect to SSRIs.

Pregabalin: This drug is primarily used to treat nerve pain. However, it is also approved for the treatment of generalized anxiety disorder. The efficacy of the drug has been proven in several studies. However, it often causes dizziness and fatigue.

Opipramol: Opipramol is an antidepressant whose efficacy has been poorly studied and is therefore only considered in exceptional cases.

Buspiron: This medicine can relieve anxiety symptoms, but it has not been as well studied as other medicines. Therefore, it is usually only used when SSRIs, for example, do not work or are not tolerated. Possible side effects of buspirone are drowsiness, nausea and insomnia.

Hydroxyzine: This antihistamine is also likely to relieve symptoms of generalized anxiety disorder. However, it is also less well studied than other drugs and is therefore rarely used.
Benzodiazepines: Benzodiazepines are sleeping pills and tranquilizers that also help to relieve anxiety. They take effect quickly, but can become addictive after just a few weeks. Therefore, these drugs are not recommended for the treatment of generalized anxiety disorder.

Active substances such as imipramine from the group of tricyclic antidepressants or the neuroleptic Quetiapin showed an effect in studies with generalised anxiety disorder. However, since there are effective and better tolerated drugs with SSRIs, these drugs are not approved for the treatment of the disorder. Doctors only prescribe these drugs if all other treatments have not helped (so-called off-label use).

There are relatively few studies that have directly compared drugs. The existing studies do not show any clear advantages for a particular active substance. However, since not every drug works the same for every individual, it may be useful to try different drugs.