Are you suffering from chronic stress and  anxiety? Have you been trying ways to deal  

with it naturally but are still struggling?  If so then this is the video for you. We  

are going to be going over some of the  most common medications that we use to  

treat anxiety so you can make a more  informed decision with your doctor.  

Hi there, I m Dr. Erik Richardson a board  certified Family Practice physician.  

I d like to welcome you to FamilyMed, a channel  that focuses giving you practical and accurate  

medical information to help you and your family.  If you think this would be something that is  

helpful to you make sure you subscribe, hit that  notification button and follow along with us.  

Today, we are going to be going over some of  the most common medications that we reach for  

when we are trying to help somebody  with anxiety. Certainly medication is  

not the only thing you should rely on when  treating anxiety, but it can be a good tool  

nothing else you have tried works and  it is starting to control your life.  

If you are suffering from it, you are not alone.  Anxiety is one of the most common health issues  

that we see in our clinics. It s estimated  that approximately 20 percent of adults in  

the United States are dealing with or have  dealt with some sort of an anxiety disorder.  

The good news though, that I want you leaving  with after watching this video, is that there  

is hope. There are options that can help and can  keep it from controlling your life. We always like  

to focus on non-medication techniques to help, so  if you are interested in learning more about that,  

check out my video on natural ways that  you can help control your anxiety.  

I guess before we go into discussing the  different medications, I find that it s  

helpful to understand a little bit about what  anxiety really is. The best way that I have  

found to describe it centers around recognizing a  normal reaction in our body that we call the fight  

or flight response. This is the mechanism that  we have developed, that when confronted with  

something dangerous, allows our body to ramp up  and either fight it or run from it. For example,  

if you are walking through a forest and a bear  charges out at you, what s going to happen?  

Your heart rate elevates, your blood vessels  constrict to allow more blood to the brain,  

adrenaline is released helping you  to either run or fight for your life.  

These are normal responses, and they are good  responses, because when the bear is coming after  

you, you need to react. Anxiety is a condition  where this response is a little too active.  

It s where these normal responses to scary or  dangerous situations, are overactive or flare  

up for things that are not dangerous or scary.  So instead of the bear charging in the forest,  

it s like walking through the trees and a fuzzy  bunny were to hop in front of you. But instead  

of thinking how cute it is, your body reacts  to it like it was a bear. So that s what is  

happening with anxiety. Normal day to day life  is triggering that flight or fight response in a  

way that starts to interfere with your ability to  function. There are some medications that can help  

you control this response especially when you ve  tried everything else, so let s get into those.  

When we look at treating anxiety there  are two general categories of treatment  

strategies that we try and use. There is an  approach when we try and treat it as you get it  

and an approach to treat it to try and prevent  it. Within each of these categories there are  

different types of medications that we can  look at using, depending on your symptoms.  

Let s look first at the treat it as you  get it kind of anxiety. This is typically  

when people have occasional panic attacks or have  situational issues that seem to bring on anxiety.  

Most commonly these are events like  traveling, flying, being in enclosed spaces,  

being in crowds or presenting things in front  of people. This would also include your panic  

attacks that can come out of nowhere and they don  t necessarily have to have a reason. Most of these  

treatments tend to center around just calming the  anxiety down or creating some sort of sedation to  

prevent these symptoms from taking you over. Probably the most common, or at least most  

talked about, medications used for this type of  anxiety, are in a class of medications called  

benzodiazepine s. These are your Xanax,  Lorazepam or Valium types of medications.  

These are a sedating medication, that can be very  effective in treating anxiety that has come on  

all of a sudden. When you have a significant panic  attack, they can be the most effective treatments.  

I m not going to go into a full discussion  of thes, but the most important thing to  

understand about this medication is it isn  t something that you should take very often.  

The biggest issue with these types of  medications is that they can be very addictive.  

They aren t designed for or intended to be taken  on a daily basis. Unfortunately, many physicians  

have been prescribed it this way, and it can be  very difficult to get off of it. I will use them  

in my practice, but we don t give very many of  them to avoid the potential of addiction. What  

I tell people, is that if you are having a severe  panic attack and everything else isn t working,  

then they can be extremely effective. But, if  you find that you need to use them frequently,  

it s better to find something safer to prevent  the symptoms from coming on in the first place.  

Another medication that we will use is  one called Propranolol. I give a better  

discussion of this medication in this video,  but in short it is a great medication to help  

for situational type anxiety, especially for  social anxiety and getting up in front of crowds.  

It helps slow the heart rate down and prevent that  significant anxiety response that can happen when  

put in those situations. It can be used as a daily  medication for more mild anxiety and it doesn t  

have the same potential to become addicted. Another effective medication that can help  

for more situational anxieties  is a one called hydroxyzine.  

This is an anti-histamine or in other words a more  powerful version of Benadryl. It can be used as  

a daily medication but the biggest problem  with it is that it makes you really sleepy,  

so most people don t do well with it on a regular  basis. It can be quite helpful though for those  

types of anxiety that affect you most  at night and keep you from sleeping.  

So those are the main kinds of medications that  are used when your anxiety doesn t happen every  

day. But what about when you are always anxious  or you are having frequent panic attacks that you  

feel like you need to be taking something all  the time. When your anxiety gets to that point  

it is better to reach for medications that can  help prevent the symptoms from coming on in the  

first place. As we mentioned before, medications  like propranolol or hydroxyzine can be used on a  

daily basis but they may not be as effective  for your more significant types of anxiety.  

When your anxiety is bad, the most common  medications we will use, belong to the family  

of medications we refer to as antidepressants.  Working with the different chemicals in the  

brain like serotonin and norepinephrine we  can help control that debilitating anxiety.  

There are two main classes of these medications  that we will use. One we call SSRI or Selective  

Serotonin Reuptake Inhibitors or SNRI or  Selective Norepinephrine Reuptake Inhibitors.  

Out of the SSRI s the most effective medications  in controlling anxiety have been Escitalopram,  

Citalopram, Paroxetine and Sertraline.  Some of the others like fluoxetine and  

fluvoxamine are felt to be effective as well  but the studies aren t as robust on those.  

SNRI s like venlavaxine and duloxetine  have been shown to be effective as well.  

Both of these classes are meant to be taken  daily to help prevent symptoms from coming  

on. It usually takes up to 4-6 weeks to see a  full effect, so they aren t meant to be taken  

on an occasional basis when you have symptoms. Another medication that is commonly used is called  

Buspirone. This is in a class of medication all  on it s own, but it does have some similar effects  

on serotonin. It s used quite a bit to treat  anxiety and is usually tolerated pretty well.  

It doesn t seem to be as effective as some of the  typical antidepressants, however it has been found  

to be useful in adding it to some of the SSRI or  SNRI s when more anxiety control is needed.  

The last one we are going to talk about  is a medication called gabapentin.  

This is actually an old anti-seizure medication,  but it has been found to be effective in treating  

anxiety in some people. It probably isn t the  first medication that most doctors will reach for,  

but it is typically tolerated pretty well, and  can be helpful when other things may not. I  

have a video specifically talking about  this one if you want to check it out.  

As you can see, there are a lot of  different medications that we can reach for  

if nothing else is working to treat your anxiety.  We can t go into specifics about each one,  

in the scope of this video, but hopefully going  over what options are out there can help you,  

in being a little more informed as you talk to  your doctor about what may be right for you.  

Talk with them about how often you are really  experiencing bothersome symptoms. If it is  

occasionally then taking periodic medications  like your benzodiazepines may be appropriate.  

If it is a fairly regular problem though it  s really best of you stay away from those  

kind of addictive medications and  focus on ones that can prevent your  

symptoms from happening in the first place. Well, I hope you found this to be helpful,  

if you did, please take the time to give this  video a like and share it with your friends. It  

helps our channel to grow and reach other people  that may need this in their life. If you haven t  

done so yet, don t leave without subscribing  and hitting that notification button so you  

don t miss out on any of our future content. So until next time, this is FamilyMed with Dr.  

Richardson and remember to take care of your  body because it s the only one you have.