Everyone experiences worry and stress at some point in their life. But for some people, overwhelming fear, heart-pounding panic, and sleepless nights are things they must deal with on a daily basis. For people with disabling anxiety, medications may be the only answer. A number of drugs provide temporary relief from symptoms. Benzodiazepines and SSRI antidepressants are some of the most commonly prescribed pharmaceutical agents to people struggling with panic, depression, and insomnia. But what are the dangers of treating anxiety disorders with drugs? Is the long-term use of these medicines safe?
The truth is that the long-term effectiveness of these drugs is still unproven. In fact, according to the American Academy of Family Physicians (AAFP), benzodiazepines often lose their effect after 4-6 months of regular use and rebound symptoms may occur on cessation of the medicine.
It is estimated that approximately 18 percent of the adult American population has some form of anxiety. People with anxiety disorders are more prone to drugs addiction. Anxiety medications are commonly prescribed to people struggling with excessive worry. These medicines are potent and have a high addiction potential. It is not surprising then that addiction to anti-anxiety drugs is a pressing problem in the United States and around the world. Read on to learn more about the dangers of prescription anxiety pill abuse.
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Anti-Anxiety Medication: Pills for Chronic Worriers
There is no magic treatment for people who are chronic worriers. Yet, medications are the cornerstone of anxiety treatment for a number of reasons. They provide temporary relief of symptoms. They help the person concentrate on other treatments, such as psychotherapy. And they may also provide the energy and motivation to exercise.
What are some anxiety medication names? Several types of medications are used to treat depression and worry. The first line of treatment is usually a selective serotonin reuptake inhibitor. SSRI antidepressants (Prozac, Zoloft, Paxil, Lexapro) increase the amount of serotonin in the brain. Serotonin is a chemical that improves mood and induces a feeling of wellbeing. The advantage of this class of drugs is that they are not addictive. The disadvantage is that they may take 6-8 weeks to become fully effective.
What does anxiety medication do? Benzodiazepines, such as Xanax, relieve anxiety by enhancing the activity of GABA, a neurotransmitter in the brain that has a sedative effect. The biggest advantage of this class of drugs is that they work very quickly, often relieving symptoms within an hour of taking the pill. The disadvantage of benzos is that they have a potential for tolerance and addiction. People taking benzodiazepines can quickly build up a tolerance, where they need progressively higher doses to get the desired effect. For this reason, doctors prescribe benzodiazepines under close supervision for short periods of time
Unfortunately, there is no over the counter anxiety medication. Benzodiazepines are powerful compounds that are controlled substances because of their direct effect on the human brain. They can cause significant side effects and there is a potential for abuse. Therefore, there is no non prescription anxiety medication.
Anti-Anxiety Medication List
Anxiety drugs are prescribed for a number of legitimate medical conditions. These powerful compounds are Schedule IV drugs, meaning they are highly regulated by the government in the United States. Benzodiazepines are available legally by prescription only. However, many people obtain benzos, or tranks or downers as they are known on the street, from the black market.
Here is an anxiety medication list categorized by the onset of action (how quickly they start working):
- Fast-onset (30-60 minutes): Valium and Tranxene
- Slow-onset: Ativan, Xanax, Klonopin
Benzodiazepines according to the duration of action (how long the effects last):
- Short-acting (effects last 3-8 hours): Halcion, Versed, Tranxene
- Intermediate-acting (effects last 11-20 hours): Xanax, Ativan, Restoril, Prosom
- Long-acting (effects last 1-3 days): Valium, Librium, Klonopin, Dalmane
Different benzos are prescribed for different conditions:
- Anxiety disorders: Valium, Xanax, Ativan, Tranxene
- Seizure disorders: Valium, Klonopin, Ativan, Tranxene
- Insomnia: Restoril, Halcion, Prosom, Dalmane
- Anesthesia: Versed, Valium, Ativan
- Muscle relaxation: Valium
- Alcohol withdrawal: Librium
Anti-Anxiety Drug Side Effects
Each year, physicians write more than 50 million benzo prescriptions. Up to 15 percent of Americans have at least one benzodiazepine in their medicine cabinet at home. Yet, even when taken with a doctor’s prescription, anxiety medication side effects can be significant. Some of the common side effects of benzodiazepines include:
- Blurred vision
- Slurred speech
- Memory problems
- Poor balance
Large doses of Xanax and other benzos can produce dangerous side effects, such as:
- Loss of coordination
- Blurred vision
Are Anxiety Medicines Addictive?
Anti-anxiety medicines are highly potent. They change the neurochemistry in the human brain. These drugs build up over time in the user’s body and can lead to physical and psychological dependence.
Benzodiazepines are prescription medications that are often given as a quick, temporary, short-term relief from symptoms of worry, panic, and insomnia. People from all walks of life can be exposed to these medicines and can potentially abuse them for their sedative effect. Addiction can occur even when taking anxiety medicines at prescribed doses under a physician’s care. People who use benzos without prescription may need to undergo drug addiction treatment to overcome their dependence.
There is a misconception that because benzodiazepines are prescription pills and not street drugs, they are safe to take. Many users remain unaware of the high addictive potential of these compounds. Some people mix anxiety drugs with other CNS depressants, such as alcohol, to boost the effect. Mixing benzodiazepines with other illicit substances or prescription medicines puts a person at high risk of a fatal overdose. In fact, nearly 60 percent of the 38,000 drug overdose deaths in the United States each year are caused by prescription medicines.
Addiction to benzos can happen in a few weeks to a couple of months. Gradually tapering the medicine is necessary after prolonged use. If someone stops taking the medication abruptly, they may experience severe withdrawal symptoms, including:
- Increased anxiety and depression
- Fast heartbeat
- Seizures (severe cases)
Commonly Abused Anti Anxiety Drugs
Benzodiazepines are prescribed for their calming properties, but these medicines are highly addictive, both with and without prescription. Some of the anxiety medicines that are commonly abused are discussed below.
Xanax (alprazolam) is the most prescribed psychiatric medicine in America and one of the most addictive when not used properly. An estimated 4 million Americans misuse Xanax. That is more than the combined number of people who abuse Ativan, Valium, and Klonopin. Xanax is a powerful and fast-acting medication that is used to treat generalized anxiety disorder. Many teenagers obtain it from the medicine cabinet at home. It is not uncommon for addicts to ignore school and work responsibilities and direct all their energies towards obtaining the drug. Once a physical dependence develops, the user may experience withdrawal symptoms if it is stopped abruptly. People who have been abusing Xanax for a long period of time need to undergo medically-supervised detoxification at rehab facilities.
Valium (diazepam) is a long-acting benzodiazepine that can quickly become addictive if it is not taken as directed by a physician. In fact, long-term treatment with this medication (for more than 4 months) can be habit-forming even when taken on a doctor’s prescription. Some of the signs of addiction to Valium include strong cravings, loss of interest in normally enjoyable activities, pulling away from family and friends, and ignoring work and family obligations. This medicine is associated with tolerance, meaning, over time, progressively higher doses are needed for effect. The user may experience withdrawal symptoms if the medication is stopped abruptly.
Librium is a psychotropic medicine that can be habit-forming if taken without a prescription. Even when taken for legitimate medical purposes, the user can develop a dependence on this drug. Many people begin abusing Librium to enhance its effects and feel better. Over time, the pathways in the brain become used to the presence of the medicine. The user then needs the drug to function normally. Prolonged use increases the chances of developing an addiction. This risk is higher in people who have other underlying mental health issues.
Klonopin can be habit-forming in only a few weeks, even when taken as prescribed by a doctor. In people who abuse this prescription pill, the brain becomes wired so that it can no longer feel relaxed or calm without the drug. Initially smaller doses can produce a sense of well-being, but with continued use, larger doses are needed to produce the same effect. This causes users to start taking more of the medicine than is prescribed, leading to addiction.
Abuse of any drug is illegal, not mentioning the health hazards it poses.
Safe Use of Anxiety Medications
Anti-anxiety medications are relatively safe when taken on occasion at the prescribed dose. However, they can be dangerous when taken without a prescription or when combined with other prescription drugs or illicit substances. Here are some ways to safely use anti-anxiety medicines:
- Take under medical supervision with a doctor’s prescription
- Do not take more than the prescribed dose
- Do not take more frequently than prescribed
- Do not drink alcohol when taking benzodiazepines
- Do not mix sleeping pills and prescription painkillers
- Some antihistamines (over-the-counter allergy and cold medications) can amplify the sedating effects of benzos
- Talk to a physician before combining benzodiazepines with antidepressants such as Prozac and Zoloft
Anyone can experience anxiety medicine addiction. Certain individuals are at greater risk of dangerous side effects. This includes people over the age of 65 who are more sensitive to the sedating effects of these medicines. People with a history of substance abuse should use benzos with extreme caution. If a pregnant or breastfeeding woman uses benzodiazepines, her baby can develop a dependence.
Non-Pharmacologic Anxiety Treatment
There are ways to reduce excessive worry without taking anxiety medication. Exercise is a powerful treatment for people struggling with this condition. Tai-chi and yoga have been shown to offer emotional, spiritual, and psychological support to individuals with mental health conditions. Meditation and mindfulness can bring about a sense of relaxation and calm. Cognitive-behavioral therapy can help anxious people by teaching them to conquer fears and control worrisome thoughts. Good sleep hygiene and a healthy balanced diet are other ways to increase general well-being.
Is anxiety medication right for me? Talk to a doctor about the pros and cons of anti-anxiety drugs. Balance the potential benefits with the side effects and take into account the addiction potential before making the decision about the best anti-anxiety drug.
- Lisa L. von Moltke, David J. Greenblatt, Medication dependence and anxiety, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181633/
- Understand the Facts, Substance Use Disorders, https://adaa.org/understanding-anxiety/related-illnesses/substance-abuse