There are several classes of medications that can reduce symptoms of clinically significant anxiety.

  • Benzodiazepines/minor tranquilizers
    • Very effective for acute anxiety
    • Some come in orally disintegrating form, allowing therapeutic action within 15 minutes
    • Very habit-forming
      • Can cause physical dependence within two weeks
      • If stopping use after a long time using, it is necessary to taper, as withdrawal can be deadly
    • Perhaps best taken just as needed
    • Tend to be ineffective or minimally effective after four weeks of use
    • Skepticism of long-term efficacy
    • Many different kinds, tailored to one’s specific needs
      • Peak blood level ranging from 30 minutes to four hours
      • Half-life ranging from 90 minutes to 250 hours
      • Various active metabolites
      • Various effects on specific areas of the benzodiazepine receptor, resulting in differing effects
        • For instance, some work more on anxiety, others on insomnia, and still others on mania

  • Vistaril and other antihistamines
    • Non-addictive
    • Relatively long duration of effect
    • Works within an hour
  • Buspar (buspirone)
    • Takes two to four weeks to reach a therapeutic plateau
    • Has fewer side effects than benzodiazepines
    • Non-addictive
    • Weak withdrawal syndrome
  •  SSRIs
    • Usually takes weeks to work
    • Good for long-term treatment
    • Non-addictive
    • Also treats depression
  •  SNRIs
    • Has the benefits of SSRIs
    • More stimulating on account of adrenergic activity

 

  • Antipsychotics
    • Good for extreme anxiety that doesn’t respond well to other agents
    • Oftentimes are useful for sleep-wake disorders
    • Deals with psychotic symptoms too
    • Some are also effective as adjuncts to antidepressants
    • Many to choose from
  • Beta-blockers
    • Good for physical anxiety
    • Can help alleviate high blood pressure
    • Work on performance anxiety
  • Neurontin (gabapentin)
    • Built-in anti-abuse mechanism
    • Taking a great amount does not lead to much more of an effect
    • Also used for insomnia and epilepsy
    • Possible utility in bipolar disorder and depression
    • Not as abusable as benzodiazepines
    • Withdrawal is difficult
  • Lyrica (pregabalin)
    • Works in the same manner as Neurontin
    • Effective at much lower doses than neurontin
    • More studies evaluating efficacy in anxiety
    • Has greater abuse risk than Neurontin

This chart details various anti-anxiety medications and activities, and compares them…

 

It, however, should not be taken for truth. It’s clean-cut image, and dense set of data points, doesn’t make it qualified source. Why? Because some of the information contradicts what I’ve read and researched about for the last several years. I’m not sure where and how they cam across their data.

What stands out is Xanax, not because they didn’t use the generic name. It’s apparently not a very popular way to deal with anxiety, but works better than all but exercise? There’s a reason why xanax is arguably the most abused drug of its class. Also, in the end, xanax tends to create more panic attacks than abort natural panic attacks. We are forced to assume that the anxiety being evaluated is acute anxiety, not anxiety that lasts a long amount of time.

Sources: http://www.attcnetwork.org, Abnormal Psychology: An Integrative Approach, Condensed Psychopharmacology 2013: A Pocket Reference for Psychiatry and Psychotropic Medications, http://americanaddictioncenters.org