The two main treatments for anxiety disorders are behavior therapy (psychotherapy) and medications. You may benefit most from a combination of the two. It may take some trial and error to discover exactly what treatments work best for you.
Also known as behavior or talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for anxiety.
Cognitive behavioral therapy is one of the most effective forms of psychotherapy for anxiety disorders. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to gradually return to the activities you have avoided because of anxiety. Through this process, your symptoms improve as you build upon your initial success.
Several different types of medications are used to treat anxiety disorders, including those below. Talk with your doctor about benefits, risks and possible side effects.
Dec. 29, 2013
- Antidepressants. These medications influence the activity of brain chemicals (neurotransmitters) thought to play a role in anxiety disorders. Examples of antidepressants used to treat anxiety disorders include fluoxetine (Prozac), imipramine (Tofranil), paroxetine (Paxil, Pexeva), sertraline (Zoloft), and venlafaxine (Effexor XR). Citalopram (Celexa) and escitalopram (Lexapro) also can be effective, but dosages of about 40 milligrams (mg) a day of citalopram or 20 mg a day of escitalopram warrant discussion of risks versus benefits.
- Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective.
- Benzodiazepines. In limited circumstances your doctor may prescribe one of these sedatives for relief of anxiety symptoms. Examples include alprazolam (Niravam, Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan). Benzodiazepines are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you've had problems with alcohol or drug abuse.
- Anxiety disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed May 17, 2012.
- Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/resourceToc.aspx?resourceID=5. Accessed May 17, 2012.
- Rakel RE. Textbook of Family Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191205553-4/0/1481/0.html#. Accessed May 18, 2012.
- Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed May 18, 2012.
- Hicks D, et al. An approach to the patient with anxiety. Medical Clinics of North America. 2010;94:1127.
- Roy-Byrne PP, et al. Anxiety disorders and comorbid medical illness. General Hospital Psychiatry. 2008;30:208.
- Rakel D. Integrative Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-2/0/1494/0.html. Accessed May 21, 2012.
- Lakhan SE, et al. Nutritional and herbal supplements for anxiety and anxiety-related disorders: Systematic review. Nutrition Journal. 2010;9:42.
- Natural medicines in the clinical management of anxiety. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 24, 2012.
- Kava linked to liver damage. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/news/alerts/kava. Accessed May 24, 2012.
- Mayo Clinic statement: Recommendations regarding the safety concern with citalopram (Celexa) therapy. Mayo Clinic. http://mayoweb.mayo.edu/mfpfc-cmte/1202citalopramStatement.pdf. Accessed June 5, 2012.
- Jacka FN, et al. Association of Western and traditional diets with depression and anxiety in women. American Journal of Psychiatry. 2010;167:305.
- Teschke R, et al. Risk of kava hepatotoxicity and the FDA consumer advisory. Journal of the American Medical Association. 2010;304:2174.
- Valerian. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/valerian. Accessed June 5, 2012.
- Miyasaka LS, et al. Passiflora for anxiety disorder. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004518.pub2/abstract. Accessed June 5, 2012.
- Support & programs. National Alliance on Mental Illness. http://www.nami.org/Template.cfm?section=Find_Support. Accessed June 5, 2012.
- Getting support. Anxiety and Depression Association of America. http://www.adaa.org/finding-help/getting-support. Accessed June 5, 2012.
- Anxiety disorders. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Accessed Aug. 26, 2011.
- Anxiety Disorders Program. Mayo Clinic. http://mayoresearch.mayo.edu/mayo/research/psych/anxiety.cfm. Accessed Sept. 9, 2011.
- Moore KM (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 12, 2011.
- Whiteside SP (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 25, 2011.
- Anxiety disorders in children and adolescents (fact sheet). National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/anxiety-disorders-in-children-and-adolescents/index.shtml. Accessed Oct. 13, 2011.