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Anti-Anxiety Agents – Brain injury

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Anti-Anxiety Agents

Anti-Anxiety Agents may lesson feelings of uncertainty, nervousness, and fear.

Anti-anxiety medications are useful in many circumstances.  For example, if a person is suffering from post-traumatic stress disorder from some kind of trauma, they often feel uncertain, fearful or anxious.  The anxiety can interfere with their sleep and it can interfere with the sufferer’s ability to leave their home or go to work.  Anxiety can be extremely debilitating.

Most sufferers feel closed in or too open.  They can develop fear in certain circumstances or all the time.  They can feel fear when trying to sleep at night or feel anxious first thing in the morning.  There are several psychiatric disorders commonly associated with anxiety.  These include the following:

PTSD. Also known as post-traumatic stress disorder, patients with PTSD experience both generalized anxiety and anxiety around things they feel remind them of the trauma they once experienced.  If the trauma was due to child abuse, for example, the anxiety is often lifelong and entrenched into the patient’s personality.

Generalized anxiety disorder (GAD).  These people feel anxiety much of the time and can’t usually place the source of their anxiety. They are often on anti-anxiety medications chronically.

Social phobia. These people have problems giving speeches, going to parties and generally socializing with other people.  When alone at home, however, they have very little difficulty.

Phobic disorder.  These people have specific fears and anxiety around contact with a particular thing or situation. The thing can be anything a person fears.  The fear can be related to a specific traumatic event or can just come spontaneously.

Panic disorder.  People with panic disorder have episodes of extreme anxiety, usually when in public somewhere.  They can have chest pain, shortness of breath and sweating.  Some feel as though they might faint or that they are having a heart attack.  This can be a very debilitating disorder that can be helped with regular use of anti-anxiety medications.

Obsessive compulsive disorder.  This is a disorder where people have fears of things like dirt, germs and uncleanliness or fear they have left the stove on and they have to check it ten times before leaving the house.  They get anxiety when they don’t follow through on their compulsions.
 
What anti-anxiety medications are available?
 
There are several and they vary in the amount of sedation they cause and in their half-life.  Some agents are short-acting and others are designed to be more long-acting.
 
SSRIs or selective serotonin reuptake inhibitors are used to treat most anxiety disorders.  They tend to be long-acting and are taken once per day.  They are taken chronically for anxiety. 
 
Older antidepressants called tricyclic antidepressants can be used and are long-acting.   They can be helpful for panic disorder, GAD, and posttraumatic stress disorder.
 
Monoamine oxidase inhibitors (MAOIs) are helpful in panic disorder, social anxiety disorder, and posttraumatic stress disorder but are not used often because they have significant side effects.
 
Buspirone or Buspar® is an anti-anxiety medication used to treat GAD. It is taken regularly every day regardless of symptoms. Benzodiazepines are used for all anxiety disorders.  They include drugs like Xanax®, Ativan®, Klonopin® and Valium®. The first two are short-acting and the second two are long-acting.  They are very good for anxiety with the only major problem being that they are potentially addicting.

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