WHAT ARE THE ADVANTAGES AND DISADVANTAGES OF USING THESE DRUGS?

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Let's look at each type of medication and their advantages and disadvantages:

I. Antidepressants

Examples: Tricyclics: Elavil, Tofranil, Norpramin, Pertofrane, Pamelor, Sinequan

MAOIs: Nardil, Parnate

SSRIs: Prozac, Paxil, Zoloft, Celexa, Luvox, Lexapro

Other: Effexor, Remeron, Cymbalta

Good News:

Generally effective

Not addictive like benzodiazepines

Tricyclics are particularly inexpensive

Bad News:

Can take weeks to months to work (usually two to six weeks)

Anxiety can become worse before it gets better

Temporary side effects: headache, sweating, dizziness, insomnia

Temporary and sometimes ongoing sexual side effects, e.g., loss of sex drive or inability to have erection or climax

Tricyclics and MAOIs can be unsafe, if not lethal, due to numerous side effects

II: Benzodiazepines

Examples: Valium, Librium, Xanax, Ativan, Klonopin

Good news:

They offer immediate relief, usually within hours

Excellent sleep aides, especially if used to initiate sleep

Bad news:

Can have sedative effect; if the dose is too high, intoxication can result

They are more likely to produce a psychological dependence and sometimes a physiological dependence—especially if you have a history of alcohol dependence

Certain types of benzodiazepines (those with a short half-life) can produce withdrawal and possibly seizure if stopped abruptly after several months; although this is a rare event, it can be life-threatening

III. BuSpar

Good News:

Doesn't lead to dependency

Sometimes used successfully to restore sexual functioning impaired by antidepressants

Bad News:

Effective with fewer individuals than the benzodiazepines

Takes three to four weeks to work

IV. Anticonvulsants

Example: Neurontin

Good News:

Seems to be effective at calming anxiety

Improves sleep

Bad News:

Side effects include sleepiness, dizziness, and “brainfog”

V. Beta-Blockers

Example: Inderal

Good News:

Reduces physical “fight-or-flight” symptoms, such as increased heart rate, sweating, shaking, and shortness of breath

Helpful in calming performance anxiety before public speaking or test-taking

 Bad News:

Very short-term effect

Physical effects, such as slowed heart rate, can be problematic

VI. Antihistamines

Examples: Benadryl, Vistaril

Good News:

Calming, sedating effect

Non-addictive, so there is less concern about potential for dependence

Bad News:

Not as effective as other medications for anxiety

Side effects include drowsiness, dry mouth, constipation, and urinary retention.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD