Anxiety Medication: Your Guide to Effective Treatment Strategies

Anxiety disorders affect millions of people worldwide, often creating significant barriers to daily functioning and overall well-being. While therapy and lifestyle changes are essential for treatment, anxiety medication can also play a crucial role in managing anxiety symptoms. In this article, we will look at the different types of medicines used to treat anxiety disorders, explaining how they work, their potential benefits, and considerations for their use. Understanding these medications can help individuals make informed decisions and collaborate with their healthcare providers to find the most effective treatment plan.

Understanding Anxiety Disorders

Anxiety is a natural response to life’s pressures, such as health concerns, financial worries, or personal relationships. However, for individuals with anxiety disorders, these feelings can become overwhelming and persistent, disrupting daily life and overall well-being. In the US, approximately 19.1% of adults struggle with anxiety disorders [23].

Over a lifetime, about 31.1% of adults will experience some form of anxiety disorder [23]. These disorders can range from mild to severe, impacting work performance, social interactions, and personal relationships [23].

Related: What is Anxiety?

Types of Anxiety Disorders

There are several types of anxiety disorders, each with distinct symptoms:

• Generalized Anxiety Disorder (GAD): GAD is characterized by persistent, excessive worry lasting for months, affecting concentration, sleep, and overall physical health [22].
• Panic Disorder: Panic disorder involves sudden, intense panic attacks, leading individuals to avoid situations that may trigger another attack [22].
• Social Anxiety Disorder: Social Anxiety Disorder causes extreme fear of social interactions, leading to avoidance of social situations [22].
• Phobia-related Disorders:  Phobia-related disorders involve intense, irrational fears of specific objects or situations, significantly limiting daily activities [22].
• Separation Anxiety Disorder: This condition where individuals, often children but sometimes adults, experience intense anxiety when separated from someone they are emotionally attached to [15].
• Obsessive-Compulsive Disorder (OCD): OCD is characterized by unwanted, repetitive thoughts (obsessions) and a compulsion to perform specific actions to alleviate the distress caused by these thoughts [25].

Purpose of Anxiety Medication

Anti anxiety medications help reduce symptoms like excessive worry and fear that comes with anxiety disorders. They work by balancing brain chemicals called neurotransmitters, such as serotonin and norepinephrine, which affect mood and anxiety. By stabilizing these chemicals, these medications can make it easier to manage symptoms and improve daily functioning [23].

Uses for Other Conditions

In addition to treating anxiety disorders, anti anxiety medication may be used to treat a range of other conditions, these include:

• Depression: SSRIs and SNRIs, typically prescribed for anxiety, are also used to treat depression due to their effectiveness in regulating mood [18, 20, 24, 31].
• Chronic Pain: SNRIs are sometimes prescribed for chronic pain conditions as they can modulate pain signals in the brain and alleviate pain symptoms [16].
• Insomnia and Muscle Spasms: Benzodiazepines, primarily used for anxiety, can be prescribed off-label for managing insomnia due to their sedative properties. Their calming effects also make them useful for treating muscle spasms [18, 26].
• Seizure Disorders: Antiseizure medications like pregabalin are effective in treating anxiety by altering the way brain cells communicate, which can help reduce anxiety symptoms [28].
• Heart Conditions: Beta-blockers, primarily used for various heart conditions, are also used off-label to manage anxiety symptoms such as rapid heart rate, sweating, and tremors [9].
• Allergies: Certain antihistamines, like hydroxyzine, can be used to treat anxiety. These medications can help reduce anxiety symptoms [7].

Types of Anxiety Medications

There are many different types of medications available to help manage anxiety disorder symptoms, and each works slightly differently.

Antidepressants

Let’s explore the various types of antidepressant medications used to treat anxiety disorders in more detail.

Selective Serotonin Reuptake Inhibitors (SSRIs):

SSRIs increase serotonin levels in the brain, a neurotransmitter associated with mood regulation. By blocking the reabsorption (reuptake) of serotonin, these medications help alleviate anxiety symptoms over time [4, 28].

Common side effects can include [4, 28]:

• Nausea
• Insomnia
• Dry Mouth
• Drowsiness
• Headache
• Weight gain
• Sexual dysfunction

SSRIs are frequently prescribed due to their efficacy and relatively favorable side effect profile. They typically require several weeks to show significant benefits [4, 28]:

List of Medications (Generic and Brand Names) [4, 28]:

• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Sertraline (Zoloft)
• Fluvoxamine (Luvox)
• Citalopram (Celexa)

SSRIs are often considered the first-line treatment for anxiety disorders in both adult and pediatric patients. They are well-regarded for their effectiveness and generally favorable side effect profile [28].

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):

SNRIs work by increasing levels of both serotonin and norepinephrine in the brain, which can help manage anxiety symptoms. They function similarly to SSRIs but also target norepinephrine, another neurotransmitter linked to mood and stress responses [4].

Common side effects may include [4, 28]:

• Nausea
• Dizziness
• Dry mouth
• Fatigue
• Increased sweating
• Constipation
• Loss of appetite
• Sexual dysfunction

SNRIs are effective for anxiety and are often used when SSRIs are not suitable. Like SSRIs, SNRIs can also take several weeks to show improvements [28].

List of Medications (Generic and Brand Names)  [4, 28]:

• Venlafaxine (Effexor XR)
• Duloxetine (Cymbalta)
• Desvenlafaxine (Pristiq)

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are used primarily to treat depression and anxiety. They increase neurotransmitters, such as serotonin and norepinephrine, in the brain. This is achieved by inhibiting the reuptake of these chemicals, which helps improve mood and reduce anxiety [4].

Potential Side Effects:

• Dry mouth
• Drowsiness
• Constipation
• Blurred vision
• Weight gain
• Difficulty urinating
• Dizziness
• Increased heart rate

Clomipramine, a TCA, has been shown to have comparable efficacy to some SSRIs in treating anxiety disorders. However, it is less well-tolerated than SSRIs, often preferred due to their more favorable side effect profile [4].

List of Medications (Generic and Brand Names)

• Clomipramine (Anafranil)
• Amitriptyline (Elavil)
• Nortriptyline (Pamelor)
• Imipramine (Tofranil)

Beta Blockers

Beta-blockers are medications primarily used to manage heart-related conditions. They influence heart and blood vessel function by blocking beta receptors in the body [14]. There are three types of beta receptors: beta-1, beta-2, and beta-3. Beta-1 receptors, primarily in the heart, affect heart rate and blood pressure. Beta-blockers bind to these receptors, slowing the heart rate and lowering blood pressure. Beta-blockers also affect beta-2 receptors, influencing smooth muscle relaxation [14].

Although not FDA-approved for anxiety, beta-blockers can help with symptoms like rapid heartbeat, sweating, and nervousness, particularly in situations like stage fright. Propranolol is an example used for this purpose [14].

Side Effects:

Common side effects of beta blockers include [14]:

• Slow heart rate (bradycardia)
• Low blood pressure (hypotension)
• Fatigue
• Dizziness
• Nausea
• Constipation
• Sexual dysfunction

Less common side effects may include [14]:

• Breathing problems (especially in asthma patients)
• Exacerbation of Raynaud’s syndrome (a condition affecting blood flow to the extremities)
• Sleep disturbances (like insomnia)

Precautions:

Beta-blockers are generally not recommended for [14]:

• People with asthma, unless they are beta-1 selective
• Individuals with certain types of slow heart rate or low blood pressure
• Those with long QT syndrome or a history of torsades de pointes

Propranolol is commonly used off-label to manage anxiety, particularly stage fright or performance anxiety. It can reduce physical symptoms of anxiety, such as rapid heartbeat and sweating [14].

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs are a class of antidepressants used to manage anxiety disorders by increasing neurotransmitter levels in the brain. These medications block the monoamine oxidase enzyme, which breaks down neurotransmitters like norepinephrine, serotonin, dopamine, and tyramine. By inhibiting this enzyme, MAOIs allow these neurotransmitters to remain active longer, improving mood and reducing anxiety symptoms [29].

Potential Side Effects

Common side effects include [29]:

• Dry mouth
• Nausea
• Diarrhea
• Constipation
• Drowsiness
• Insomnia
• Dizziness
• Lightheadedness

Patch-form MAOIs may cause skin reactions. Patients should be cautious of drug interactions and dietary restrictions.

List of Medications (Generic and Brand Names)

Some of the MAOIs that may be used to treat anxiety disorders include [29]]:

• Isocarboxazid (Marplan)
• Phenelzine (Nardil)
• Selegiline (Emsam)
• Tranylcypromine (Parnate)

MAOIs are effective for various forms of depression and anxiety disorders, including panic disorder and social phobia. However, due to their dietary restrictions and side effects, they are not typically the first choice for treating mental health disorders [29].

Benzodiazepines

Benzodiazepines are a class of GABAergic medications that enhance the effect of the neurotransmitter GABA (gamma-aminobutyric acid) in the brain. This has a calming effect on the nervous system, helping to reduce anxiety, promote sleep, and relax muscles [18, 22]. By increasing GABA activity, benzodiazepines reduce brain activity, which helps alleviate severe anxiety symptoms and promotes relaxation [13, 22].

List of Medications (Generic and Brand Names)

In the United States, some commonly prescribed benzodiazepines include [3, 13, 28]:

• Alprazolam (Xanax)
• Diazepam (Valium)
• Lorazepam (Ativan)
• Clonazepam (Klonopin)

Potential Side Effects

Common side effects of benzodiazepines include [3, 13, 28]:

• Drowsiness
• Dizziness
• Confusion
• Memory problems
• Balance and coordination issues

Risks and Considerations

Benzodiazepines are commonly prescribed for short-term use due to the risk of of developing physical dependence and tolerance [28]. They can be habit-forming, leading to dependency if used for long periods [13]. Additionally, abrupt discontinuation of the medication can lead to severe withdrawal symptoms [13].

Who Should Avoid Benzodiazepines

Benzodiazepines are generally not recommended for [3, 13]:

• Individuals with a history of substance abuse
• Pregnant or breastfeeding women
• Older adults, due to an increased risk of falls and cognitive impairment
• People with certain medical conditions, such as severe respiratory problems or liver disease

It is crucial for anyone considering benzodiazepines for anxiety to consult with their healthcare provider to weigh the benefits and risks carefully.

Related: Alternatives to Xanax: Is Anything as Effective?

Antipsychotics

Antipsychotic medications are sometimes used to manage anxiety disorders, mainly when other treatments haven’t been effective. These medications influence the levels of certain chemicals in the brain, such as dopamine and serotonin. By adjusting these chemical signals, antipsychotics can help reduce anxiety symptoms and improve mood [17].

Potential Side Effects:

Like all medications, antipsychotics can have side effects. Common ones include [17].:

• Drowsiness
• Weight gain
• Dry mouth
• Dizziness
• Blurred vision
• Changes in blood sugar levels

Second-generation antipsychotics like quetiapine are sometimes used as add-on treatments for anxiety. They can be effective but come with higher risks of side effects [28]. It is important to discuss these potential side effects with a mental health professional, psychiatrist, or other healthcare provider to manage them effectively.

List of Medications (Generic and Brand Names)

Here are some antipsychotics that may be prescribed for anxiety disorders [17].:

• Aripiprazole (Abilify)
• Asenapine (Saphris)
• Brexpiprazole (Rexulti)
• Cariprazine (Vraylar)
• Clozapine (Clozaril)
• Lurasidone (Latuda)
• Olanzapine (Zyprexa)
• Paliperidone (Invega)
• Quetiapine (Seroquel)
• Risperidone (Risperdal)
• Ziprasidone (Geodon)

These medications are generally considered when other treatments have not been successful, and they should be used under the guidance of a healthcare provider.

Antihistamines

Hydroxyzine is an antihistamine primarily used to treat anxiety, as well as issues such as difficulty sleeping, nausea, vomiting, itching, skin rashes, and allergies [21]. It works by blocking histamine receptors in the brain, which helps to reduce feelings of anxiety [21].  It can relieve symptoms like nervousness, fearfulness, excessive worrying, trouble sleeping, difficulty concentrating, and irritability  [21]. Symptoms of anxiety or insomnia may improve within hours of taking hydroxyzine [21].

Side Effects:

Common side effects of hydroxyzine include  [21]:

• Dizziness
• Drowsiness
• Fatigue
• Dry mouth
• Urinary retention
• Blurred vision
• Confusion
• Irritability
• Headache

Serious side effects are less common but can include  [21]:

• Allergic reactions (difficulty breathing, hives, swelling of lips, tongue, or face)
• Increased heart rate or unsafe heart rhythms
• Confusion or hallucinations
• Priapism (a persistent erection in males)
• Skin rash known as acute generalized exanthematous pustulosis (AGEP)

Usage and Precautions [21]:

• Hydroxyzine should not be used in the first trimester of pregnancy due to potential risks identified in animal studies. It can be used in later trimesters but not during or just before labor. It is not recommended for breastfeeding mothers as it may affect milk production and infant health.
• Patients should avoid driving or operating machinery until they understand how hydroxyzine affects them.
• Alcohol and illegal drugs should be avoided while taking this medication.
• If a dose is missed, take it as soon as possible, but do not double the next dose.
• Overdoses may cause severe drowsiness, dry mouth, rapid heartbeat, confusion, and even seizures. Immediate medical attention is necessary if an overdose occurs.

Hydroxyzine does not have a black box warning and is not known to cause long-term issues when used as directed. Regular consultations with a healthcare provider are recommended to assess its continued effectiveness.

Hydroxyzine can interact with other medications, particularly those with anticholinergic effects, other antihistamines, and drugs that increase the heart’s QT interval. Always consult a healthcare provider for personalized advice before starting any new medication.

Buspirone

Buspirone is a medication used to treat anxiety disorders [8]. It works by balancing the levels of dopamine and serotonin in the brain, which are chemicals that help regulate mood [8]. This balancing act helps alleviate symptoms of anxiety and improve overall mood [8].

Potential Side Effects

While buspirone can be effective in managing anxiety, it may cause some side effects. Common ones include [8]:

• Drowsiness
• Dizziness
• Headache
• Nausea
• Trouble sleeping

More severe side effects, which require immediate medical attention, include [8]:

• Allergic reactions (e.g., skin rash, itching, swelling of the face, lips, or throat)
• Symptoms of serotonin syndrome (e.g., muscle stiffness, irregular heartbeat, high fever, confusion, sweating, or seizures).

Important Considerations

Before starting buspirone, inform your healthcare provider if you have any kidney or liver disease, if you are pregnant, breastfeeding, or have allergies to this medication.

Drug Interactions

Buspirone should not be used with certain medications, including [8]:

• Linezolid
• MAO inhibitors (e.g., Carbex, Eldepryl, Marplan)
• Methylene blue
• Procarbazine

It can also interact with [8]:

• Diazepam
• Digoxin
• Diltiazem
• Erythromycin
• Grapefruit juice
• Haloperidol
• Various antidepressants and anticonvulsants
• Rifampin
• Ritonavir
• Certain antifungals (e.g., itraconazole)
• Warfarin

Monitoring and Safety

Regular check-ups with your healthcare provider are necessary to monitor your progress [8]. It might take 1 to 2 weeks to notice improvements in anxiety [8].  Be cautious of potential drowsiness or dizziness and avoid activities requiring full mental alertness until you understand how the medication affects you [8]. 

Buspirone should be stored at room temperature, away from light, and tightly closed to maintain its effectiveness [8]. Always keep it out of children’s reach and dispose of unused medication after its expiration date [8]. 

Alpha-Adrenergic Agonists

Alpha-adrenergic receptor medications affect the body’s response to stress [30]. They work on specific receptors in the brain and nervous system called alpha-adrenergic receptors [30]. These medications are often used to treat anxiety and related conditions [30].

These medications target alpha-adrenergic receptors, part of the body’s autonomic nervous system [30]. By affecting these receptors, the drugs help to regulate the body’s response to stress and anxiety [30].  This can lead to reduced symptoms of anxiety by calming the overactive parts of the nervous system [30].

What They Treat

Alpha-adrenergic receptor medications are primarily used to treat anxiety disorders, including:

• Generalized Anxiety Disorder (GAD)
• Social Anxiety Disorder (SAD)
• Post-Traumatic Stress Disorder (PTSD)
• Panic Disorder

List of Medications

• Clonidine (Catapres)
• Guanfacine (Intuniv)

Side Effects

These medications can have side effects, including [30]:

• Drowsiness or fatigue
• Dry mouth
• Dizziness or lightheadedness
• Constipation
• Headache
• Low blood pressure

Risks and Precautions [30]:

• Risk of Low Blood Pressure: These medications can lower blood pressure, so it’s important to monitor blood pressure regularly.
• Sedation: They can cause drowsiness, which may affect daily activities.
• Interactions with Other Medications: Some medications may interact with other drugs, so it’s important to inform your doctor about all your medications.
• Sudden Discontinuation: Stopping the medication abruptly can lead to withdrawal symptoms or worsening of anxiety, so a healthcare provider should supervise any changes in dosage.

General Precautions When Taking Medications

When starting a new medication for anxiety, it’s important to follow specific guidelines to ensure safety and effectiveness. Proper medication management can significantly impact your treatment’s success and help avoid potential complications. Here are key practices to keep in mind:

1.  Practice Safe Storage: Store your medications in their original containers away from direct sunlight. Place them in a secure location out of reach of children and pets to prevent accidental ingestion or misuse.
2. Do Not Share Medication: Medications are prescribed based on individual health needs and conditions. Sharing your medicines with others, even if they have similar symptoms, is unsafe and potentially harmful. Each person’s health history and medication response can vary.
3. Consult with Your Healthcare Provider: Discuss your complete medical history and current medications with your doctor before starting any anxiety medication. This includes informing them about any history of substance abuse, as some medications may be habit-forming or interact with other substances.
4. Adhere to Prescribed Dosage: Follow the prescribed dosage exactly. Taking more than recommended can lead to severe side effects, including overdose, which can be life-threatening. Always stick to your healthcare provider’s instructions.
5. Avoid Alcohol and Other Depressants: Mixing anxiety medications with alcohol or other depressants can increase the risk of severe side effects, such as respiratory depression and excessive sedation. Avoiding these substances to ensure the medication works effectively and safely.
6. Avoid Abrupt Discontinuation: Do not stop taking your medication suddenly, especially with benzodiazepines. Abrupt discontinuation can cause withdrawal symptoms, including seizures. Consult your healthcare provider for a safe tapering plan to discontinue the medication.
7. Monitor for Side Effects: Be alert to side effects like drowsiness, dizziness, or cognitive impairment. Report any severe or persistent side effects to your healthcare provider so that your treatment plan can be adjusted as needed.

Always consult with your healthcare provider before starting or changing medication. They can provide personalized advice and ensure your treatment plan is safe and effective for your needs. Following these guidelines will help maximize the benefits of your anxiety medication while minimizing risks.

Alternative Treatments for Anxiety

Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is a non-invasive therapy that uses magnetic fields to stimulate nerve cells in the brain. It is FDA-indicated for a range of mental health disorders including depression, but research is also exploring its “off-label” effectiveness for anxiety disorders, including Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD) [6]. TMS involves placing a magnetic coil against the scalp [1,6]. The coil generates magnetic pulses that penetrate the brain and stimulate nerve cells in targeted areas [1, 6]. This stimulation aims to enhance brain activity associated with mood regulation and reduce symptoms of anxiety [6].

Is TMS Effective?

Studies on TMS for anxiety disorders, such as GAD and PTSD, have shown promising results. Patients experienced noticeable improvements, with some studies suggesting that up to 60% of patients had reduced symptoms [6]. Stimulating the right dorsolateral prefrontal cortex (rDLPFC) with high-frequency stimulation might be particularly effective [6]. However, more research is needed to confirm how well TMS works compared to other treatments.

Side Effects

TMS is generally well-tolerated, but some patients may experience side effects, including:

• Headaches: Commonly reported and usually mild.
• Discomfort at the stimulation site: Some patients feel soreness or discomfort where the magnetic coil is placed.
• Muscle twitching: Involuntary muscle movements may occur during treatment [6].

Effectiveness When Combined with Other Treatments:

According to the Anxiety and Depression Association of America, TMS can be especially effective when combined with other treatments like psychotherapy. Evidence shows that TMS can help reduce anxiety symptoms, particularly when used alongside psychotherapy to treat generalized anxiety disorder and PTSD [1]. For patients who don’t respond well to usual treatments, TMS combined with medication or psychotherapy has shown improvements. A meta-analysis found that TMS has a significant effect in treating both GAD and PTSD, making it a valuable addition to other treatments [6, 27].

Psychotherapy

Psychotherapy, often referred to as talk therapy or psychological counseling, is a key treatment modality for anxiety disorders. It involves working with a trained therapist to address and manage the symptoms of anxiety. The most effective form of talk therapy for anxiety is cognitive behavioral therapy (CBT), which focuses on identifying and changing negative thought patterns and behaviors accompanying anxiety. CBT often involves techniques like exposure therapy, where individuals gradually face their fears in a controlled setting to build confidence and lessen avoidance behaviors. [2, 19]

Psychotherapy helps individuals with anxiety disorders in the following ways [2, 19]:

• Identifying Triggers: Therapy assists patients in recognizing the specific thoughts, situations, or behaviors that trigger their anxiety.
• Developing Coping Strategies: Patients learn coping mechanisms to manage anxiety symptoms and reduce their impact on daily life.
• Changing Thought Patterns: CBT helps individuals reframe negative thoughts into more positive or realistic ones, which can decrease anxiety levels.
• Building Confidence: Through gradual exposure to feared situations, patients can develop a sense of control and confidence in managing their anxiety

Combining Medication and Psychotherapy

Combining psychotherapy with antidepressant medication is generally more effective for treating anxiety disorders than using medication alone [10, 19]. Research shows that this combined approach leads to better results for conditions like major depression, panic disorder, and obsessive-compulsive disorder (OCD) [10, 19 For instance, data from one study found that patients receiving combined treatment were 48% more likely to have a positive outcome than those who only took medication [10].

Frequently Asked Questions

What is the most prescribed medication for anxiety?

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medications for anxiety disorders. Among SSRIs, sertraline (Zoloft) is particularly prevalent, with 37% of prescriptions for anxiety disorders in the United States being for this drug [5]. Other widely used SSRIs include escitalopram (Lexapro) and paroxetine (Paxil), which are also frequently prescribed to manage anxiety [5].

What is the most effective anxiety medication with the least side effects?

Among the medications used for anxiety, buspirone stands out for its effectiveness and relatively favorable side effect profile. In terms of efficacy, buspirone has an odds ratio of 0.88, indicating it is a bit less effective compared to SSRIs but still significantly better than a placebo [5]. Unlike benzodiazepines, which are effective but can lead to dependency and significant side effects, buspirone does not carry the same risk of addiction. It is less likely to cause sedation or cognitive impairment  [5]. However, individual medication responses can vary, so what works best for one person may not be the same for another [5].

Who can prescribe anxiety medications?

Anxiety medications can be prescribed by various healthcare professionals, including primary care physicians, psychiatrists, psychiatric nurse practitioners, and physician assistants. Clinical psychologists with extra training and certification may also prescribe these medications in some regions. The specific prescription ability depends on the qualifications of your prescribing doctor and local regulations.

Finding the Right Anxiety Medication for You

Choosing the right medication for anxiety can be a crucial step toward managing symptoms and improving quality of life. Each medication type has unique benefits and potential side effects, making it important to work closely with a healthcare provider to find the best fit for your needs. While medications can provide significant relief, they are most effective when combined with therapy and lifestyle changes. By staying informed and engaged in your treatment plan, you can take proactive steps toward a more balanced and manageable life.

Ready to Take the Next Step in Managing Your Anxiety?

At Neuro Wellness Spa, we offer comprehensive anxiety treatments tailored to your needs, including in-person and online psychiatry for medication management, a brief integrative psychotherapy program which utilizes therapies that are effective for treating and managing anxiety, as well as TMS therapy which stimulates regions of the brain that have been affected by anxiety disorders.

Whether you prefer in-person visits or the convenience of virtual anxiety treatment, our team is here to support you every step of the way. Don’t wait to find the relief and support you deserve. Contact us today to schedule your appointment and take the first step towards a more balanced and fulfilling life.

References

1. Anxiety & Depression Association of America. Transcranial Magnetic Stimulation (TMS). https://adaa.org/finding-help/transcranial-magnetic-stimulation
2. Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2), 93–107. https://doi.org/10.31887/DCNS.2017.19.2/bbandelow
3. Bounds CG, Patel P. Benzodiazepines. [Updated 2024 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470159/
4. Cassano, G. B., Baldini Rossi, N., & Pini, S. (2002). Psychopharmacology of anxiety disorders. Dialogues in Clinical Neuroscience, 4(3), 271–285. https://doi.org/10.31887/DCNS.2002.4.3/gcassano
5. Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., Leucht, S., Ruhe, H. G., Turner, E. H., Higgins, J. P. T., Egger, M., Takeshima, N., Hayasaka, Y., Imai, H., Shinohara, K., Tajika, A., Ioannidis, J. P. A., & Geddes, J. R. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet, 391(10128), 1357–1366. https://doi.org/10.1016/S0140-6736(17)32802-7
6. Cirillo, P., Gold, A. K., Nardi, A. E., Ornelas, A. C., Nierenberg, A. A., Camprodon, J., & Kinrys, G. (2019). Transcranial magnetic stimulation in anxiety and trauma-related disorders: A systematic review and meta-analysis. Brain and Behavior, 9(6), e01284. https://doi.org/10.1002/brb3.1284
7. Cleveland Clinic. Antihistamines. https://my.clevelandclinic.org/health/drugs/21223-antihistamines
8. Cleveland Clinic. Buspirone Tablets. https://my.clevelandclinic.org/health/drugs/20084-buspirone-tablets
9. Cleveland Clinic. (n.d.). Do beta-blockers work for anxiety? Cleveland Clinic. https://health.clevelandclinic.org/beta-blockers-for-anxiety
10. Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds, C. F., 3rd (2014). Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry, 13(1), 56–67. https://doi.org/10.1002/wps.20089
11. Drugs.com. Propranolol (Ingredient). https://www.drugs.com/ingredient/propranolol.html
12. Drugs.com. Propranolol. https://www.drugs.com/propranolol.html
13. Edinoff, A. N., Nix, C. A., Hollier, J., Sagrera, C. E., Delacroix, B. M., Abubakar, T., Cornett, E. M., Kaye, A. M., & Kaye, A. D. (2021). Benzodiazepines: Uses, dangers, and clinical considerations. Neurology International, 13(4), 594–607. https://doi.org/10.3390/neurolint13040059
14. Farzam K, Jan A. Beta Blockers. [Updated 2023 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532906/
15. Feriante J, Torrico TJ, Bernstein B. Separation Anxiety Disorder. [Updated 2023 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560793/
16. Ferreira, G. E., Abdel-Shaheed, C., Underwood, M., Finnerup, N. B., Day, R. O., McLachlan, A., Eldabe, S., Zadro, J. R., & Maher, C. G. (2023). Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. BMJ, 380, e072415. https://doi.org/10.1136/bmj-2022-072415
17. Garakani, A., Freire, R. C., Buono, F. D., Thom, R. P., Larkin, K., Funaro, M. C., Salehi, M., & Perez-Rodriguez, M. M. (2022). An umbrella review on the use of antipsychotics in anxiety disorders: A registered report protocol. PloS One, 17(6), e0269772. https://doi.org/10.1371/journal.pone.0269772
18. Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020). Pharmacotherapy of anxiety disorders: Current and emerging treatment options. Frontiers in Psychiatry, 11, 595584. https://doi.org/10.3389/fpsyt.2020.595584
19. Mayo Clinic. Anxiety Disorders. https://www.mayoclinic.org/diseases-conditions/anxiety/diagnosis-treatment/drc-20350967
20. NHS. Overview – Generalised anxiety disorder in adults. https://www.nhs.uk/mental-health/conditions/generalised-anxiety-disorder/overview/
21. National Alliance on Mental Illness. Hydroxyzine (Vistaril). https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/hydroxyzine-vistaril/
22. National Institute of Mental Health. Anxiety Disorders. https://www.nimh.nih.gov/health/topics/anxiety-disorders
23. National Institute of Mental Health. Any Anxiety Disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
24. National Institute of Mental Health. Mental Health Medications. https://www.nimh.nih.gov/health/topics/mental-health-medications
25. National Institute of Mental Health. Obsessive-Compulsive Disorder. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd
26. Pharmacological Treatment of Mental Disorders in Primary Health Care. Geneva: World Health Organization; 2009. Chapter 6, Medicines used in generalized anxiety and sleep disorders. Available from: https://www.ncbi.nlm.nih.gov/books/NBK143206/
27. Rodrigues, P. A., Zaninotto, A. L., Neville, I. S., Hayashi, C. Y., Brunoni, A. R., Teixeira, M. J., & Paiva, W. S. (2019). Transcranial magnetic stimulation for the treatment of anxiety disorder. Neuropsychiatric Disease and Treatment, 15, 2743–2761. https://doi.org/10.2147/NDT.S201407
28. Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert Opinion on Pharmacotherapy, 19(10), 1057–1070. https://doi.org/10.1080/14656566.2018.1491966
29. Sub Laban T, Saadabadi A. Monoamine Oxidase Inhibitors (MAOI) [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539848/
30. Taylor, B. N., & Cassagnol, M. Alpha-Adrenergic Receptors. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539750/
31. Wilson TK, Tripp J. Buspirone. [Updated 2023 Jan 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK531477/