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FDA-Approved and Off-Label Medications for Anxiety

Written by:
Rabia Khaliq
MSc in Applied Psychology
Reviewer:
Dr. David Toomey
DO
Medical Disclaimer
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs. Read more

It is natural to experience anxiety at times. However, persistent and intense anxiety may be a symptom of a psychiatric disorder. Anxiety is characterized by fear, unease, worry, and restlessness. Approximately 33.7% [1*] of the global population will experience an anxiety disorder at some point. General anxiety disorders affect about 3.1% [2*] of the American population. The good news is that anxiety treatment is available now in many forms, and it is possible to treat and manage anxiety disorders enabling a patient to live a productive life.

It’s advisable to consult a medical professional for personalized anxiety disorder treatment. Depending on a patient’s disorder, the doctor may prescribe anxiety medications, psychotherapy, or a combination of both treatments for better results. In this post, let’s review FDA-approved medications prescribed for these types of mental disorders.

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What is FDA Approval?

The Food and Drug Administration (FDA) is a regulatory body that ensures the safety, efficacy, and security of human medication, veterinary drugs, and medical, biological, and cosmetic products. An FDA-approved [3*] medication implies the medication is reviewed and determined by the Center for Drug Evaluation and Research (CDER) to have more benefits than any potential risks or side effects.

Types of FDA-approved Medications for Anxiety

According to the Anxiety and Depression Association of America (ADAA), there are four major categories of medication used to treat anxiety disorders. These categories are:

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are usually prescribed to treat depression. However, doctors also prescribe these meds for anxiety disorders.

SSRIs are a first-line anxiety disorder treatment. The medication inhibits the reabsorption of serotonin back into the brain cells that regulate a patient’s mood. SSRIs reach a steady state of effectiveness within two to six weeks of use for most individuals. SSRIs are not potentially addictive.

Types of SSRIs medications include:

Benzodiazepines

Benzodiazepines are sedative medications that alleviate anxiety disorders’ physical symptoms, such as excessive sweating and tense muscles. A patient can experience relief from their symptoms in about one or two hours after intake. Since benzodiazepines work quickly, they can be used with SSRIs during the two to four week period when SSRIs take effect. Benzodiazepines are prescribed for short-term use only since they can be highly addictive and too often readily abused.

The list of medicines for anxiety under this category includes:

  • Alprazolam (Xanax)
  • Chlordiazepoxide (Librium)
  • Diazepam (Valium)
  • Lorazepam (Ativan)

A doctor will conduct a detailed assessment of your symptoms before prescribing medications.

Serotonin-norepinephrine Reuptake Inhibitors (SNRIs)

Like SSRIs, serotonin-norepinephrine reuptake inhibitors treat depression and anxiety disorders. These medications are also prescribed for the treatment of chronic pain.

SNRIs’ work by inhibiting the reabsorption of norepinephrine and serotonin chemicals back into the brain cells. These medications take several weeks to reach their steady state and maximum efficacy.

Types of SNRIs prescribed for anxiety include Duloxetine (Cymbalta) and Venlafaxine (Effexor XR).

Buspirone

Buspirone (BuSpar) antianxiety medication is used for the treatment of anxiety symptoms. It has fewer side effects and there is no risk of addiction.

Best anxiety medication

Off-Label Anxiety Medications

Tricyclic Antidepressants

Tricyclic antidepressants (TCA) are older medications that are used in the treatment of depression. Though TCAs [4*] are an effective option for the treatment of anxiety disorders, In general, clinicians prefer to prescribe SSRIs [5*] since they have fewer side effects. However, some people might find relief from TCAs if other standard medications are ineffective.

These medications block the reabsorption of norepinephrine and serotonin back into the cells. This process increases the level of neurotransmitters in the brain.

Types of TCAs include:

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

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Beta-blockers

Beta-blockers are usually prescribed for patients with heart conditions such as high blood pressure, however they are effective in the treatment of the symptoms of anxiety. Examples of beta blockers include Atenolol (Tenormin) and Propranolol [6*] (Inderal).

Monoamine Oxidase Inhibitors (MAOIs)

Monoamine oxidase inhibitors are one of the oldest depression treatment medications on the market. MAOIs may be prescribed off-label to alleviate social phobia and panic disorder symptoms.

MAOIs types include:

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

Conclusion

A person with disabling symptoms of anxiety should consult a doctor for a professional assessment and treatment for anxiety. The doctor may recommend certain medications or other interventions depending on the patient’s condition.

Though anxiety disorders are common psychiatric conditions, it is possible to treat and manage these conditions effectively. Doctors usually prescribe FDA-approved medications depending on the unique nature of a patient’s condition. Patients should always consult a clinician in case of severe side effects, dosage review and overall disease state management.

Sources

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6 sources
  1. Epidemiology of anxiety disorders in the 21st century. (2015)
    Source link
  2. Anxiety Disorders - Facts & Statistics
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  3. Development & Approval Process | Drugs
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  4. Overview of antidepressants currently used to treat anxiety disorders. (1999)
    Source link
  5. Anxiety disorders: a review of tricyclic antidepressants and selective serotonin reuptake inhibitors. (2000)
    Source link
  6. Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis. (2016)
    Source link
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Written by:
Rabia Khaliq
MSc in Applied Psychology
Reviewer:
Dr. David Toomey
DO
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