Xanax has boxed warnings. These are the most serious warnings from the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.
Using benzodiazepines, even as prescribed, can lead to physical dependence and withdrawal if you stop taking the drug suddenly. Withdrawal can be life threatening.
Using benzodiazepines can also lead to misuse and addiction. Misuse of benzodiazepines increases your risk of overdose and death.
Only take these drugs as your doctor prescribes. Talk with your healthcare professional if you have any concerns about safely taking a benzodiazepine.
Most people feel anxious at some point in their lives, and the feeling often goes away by itself. An anxiety disorder is different. If you’ve been diagnosed with one, you may need help managing anxiety. Treatment typically consists of psychotherapy and medication.
While drugs do not cure anxiety, they can help you manage your symptoms, so you can function well and feel better in your day-to-day life.
Many types of medications are available. Because every person is different, you and your doctor may have to try several medications to find the right one for you.
Benzodiazepines are sedatives that can help relax your muscles and calm your mind. They work by increasing the effects of certain neurotransmitters, which are chemicals that relay messages between your brain cells.
- alprazolam (Xanax)
- chlordiazepoxide (Librium)
- clonazepam (Klonopin)
- diazepam (Valium)
- lorazepam (Ativan)
Benzodiazepines are typically used for short-term treatment of anxiety. This is because they can increase drowsiness and cause problems with balance and memory. They can also be habit-forming. There’s an increasing number of cases of substance use disorder involving benzodiazepine.
It’s important to only use these drugs until your doctor prescribes other treatment. However, if you have panic disorder, your doctor may prescribe benzodiazepines for up to 1 year.
In addition to drowsiness and memory problems, taking benzodiazepines can also cause:
- vision problems
- feelings of depression
If you’ve taken a benzodiazepine regularly for more than 2 weeks, it’s important to not stop the pills suddenly, as this could cause unwanted withdrawal symptoms. Instead, talk with your doctor about slowly tapering off your dosage to reduce your risk of seizure.
Buspirone is used to treat both short-term anxiety and chronic (long-lasting) anxiety disorders. It’s not fully understood how buspirone works, but it’s thought to affect chemicals in the brain that regulate mood.
Buspirone can take up to several weeks to become fully effective. It’s available as a generic drug as well as the brand-name drug Buspar.
Types of antidepressants include:
Selective serotonin reuptake inhibitors (SSRIs) work by increasing levels of serotonin, a neurotransmitter that affects mood, sexual desire, appetite, sleep, and memory. SSRIs are typically started at a low dose that your doctor gradually increases.
Examples of SSRIs used to treat anxiety include:
SSRIs can cause a variety of side effects, but most people tolerate them well. Side effects can include:
If you have a concern about a particular side effect, talk with your doctor.
Tricyclics work as well as SSRIs do for treating most anxiety disorders, except obsessive-compulsive disorder (OCD). It’s thought that tricyclics work similarly to SSRIs. Like SSRIs, tricyclics are started at a low dose and then increased gradually.
Examples of tricyclics used for anxiety include:
Tricyclics are older drugs that are used less often because newer drugs cause fewer side effects.
Side effects of tricyclics
- urinary retention
- nausea and vomiting
- blurred vision
- weight gain
Side effects can often be controlled by changing the dose or switching to another tricyclic.
Monoamine oxidase inhibitors (MAOIs) are used to treat panic disorder and social phobia. They work by increasing the number of neurotransmitters that regulate mood.
MAOIs that are FDA approved to treat depression but used off-label for anxiety include:
- isocarboxazid (Marplan)
- phenelzine (Nardil)
- selegiline (Emsam)
- tranylcypromine (Parnate)
Like tricyclics, MAOIs are older drugs that cause more side effects than newer drugs. Some side effects
- dry mouth
Certain medications, including SSRIs, some birth control pills, pain relievers, such as acetaminophen and ibuprofen, cold and allergy medications, and herbal supplements can react with MAOIs.
Using an MAOI with medications can dangerously increase your blood pressure and cause other potentially life threatening side effects.
Beta-blockers are most often used to treat heart conditions. They’re also used off-label to help relieve the physical symptoms of anxiety, especially in social anxiety disorder.
Your doctor may prescribe a beta-blocker such as propranolol (Inderal) to help reduce your anxiety symptoms in stressful situations, such as attending a party or giving a speech.
Beta-blockers don’t usually cause side effects in everyone taking them.
Some potential side effects can include:
- cold fingers or toes
Other side effects may include:
- trouble sleeping
- shortness of breath
There are a variety of at-home interventions that can help ease your anxiety symptoms. Several interventions can also be practiced in addition to taking medications.
Examples of these interventions include:
Exercise can help reduce stress and enhance your overall sense of well-being, according to the Anxiety and Depression Association of America (ADAA).
It helps produce neurotransmitters known as endorphins. These neurotransmitters are your body’s natural pain relievers and can also help improve your sleep quality.
The ADAA reports that even short exercise sessions (about 10 minutes at a time) are effective in helping lift your mood.
Taking 15-minute intervals of quiet time and meditation to focus on deep breathing and relaxation can help calm your anxiety. You can listen to music or repeat a motivational mantra on a regular basis.
Sipping chamomile tea or taking a chamomile supplement might help to ease anxiety symptoms.
A 2016 double-blind study published in the Phytomedicine journal focused on individuals with generalized anxiety disorder.
The study found that study participants who took 500-milligram chamomile supplements three times per day on a daily basis reported a reduction in moderate to severe generalized anxiety.
Drinking chamomile tea has also been shown to help reduce anxiety.
Smell aromatherapy oils
Smelling diluted aromatherapy oils may help reduce anxiety, according to an article published in the Evidence-Based Complementary and Alternative Medicine journal.
Examples of essential oils used to provide anxiety relief include:
Sometimes caffeine may make you feel jittery and more anxious. Avoiding it can help some people reduce their anxiety.
Your doctor can help you find the best course of treatment for your anxiety. Proper treatment will likely include psychotherapy and medication.
Be sure to follow their instructions when taking anxiety medications and let them know about any side effects you have. Also, ask any questions you have about your condition or your treatment, such as:
- What side effects could I have from this medication?
- How long will it take to start working?
- Does this medication interact with any other drugs I’m taking?
- Can you refer me to a psychotherapist?
- Could exercise help relieve my anxiety symptoms?
If you feel a medication isn’t giving you the desired results or is causing unwanted side effects, talk with your doctor before you stop taking it.