Over the Counter Antianxiety Medications

OTC anxiety medication are drugs that are sold without prescription for the treatment of mild symptoms. Some common OTCs are for relief of pain, fever, coughs, allergies, gastro-intestinal symptoms and skin conditions. OTCs are generally low dose, safe and effective for use by the general public. It is of utmost importance to use these drugs as recommended. The range of drugs which can be bought off the shelf in a drug store, pharmacy or supermarket is limited, as the risk of exceeding the recommended dose, frequency of use when abused could lead to adverse effects.

Antianxiety medications usually require a prescription written by a registered medical practitioner. The prevalence of anxiety disorder is growing in all populations. Anxiety is a common everyday reaction that characterizes how individuals are feeling. It is in fact quite normal to experience anxiety or nervousness about a new situation or public appearance. Nervousness, sweating and palpitations are few of the symptoms experienced.

Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. Anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. These feelings can interfere with daily activities such as job performance, school work, and relationships.

Antianxiety (anxiolytic, anti-panic) medications

Anxiety disorders are treatable. If you think you have an anxiety disorder, talk to your doctor. With proper treatment, many people with anxiety disorders can lead normal, fulfilling lives. In general, anxiety disorders are treated with medication, specific types of psychotherapy, or both. Treatment choices depend on the type of disorder, the person’s preference, and the expertise of the clinician.

People with anxiety disorders who have already received treatment should tell their clinician about that treatment in detail. If they received medication, they should tell their doctor what medication was used, what the dosage was at the beginning of treatment, whether the dosage was increased or decreased while they were under treatment, what side effects occurred, and whether the treatment helped them become less anxious. If they received psychotherapy, they should describe the type of therapy, how often they attended sessions, and whether the therapy was useful.

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Anxiolytics

It may become necessary for you to take anxiolytic medications. One group is called benzodiazepine. The mode of action is the drug targets GABA receptors in the brain. This reaction elicits a feeling of relaxation. Popular benzodiazepines include diazepam, lorazepam (Ativan), Xanax, and Valium. Other groups of drugs used to treat anxiety include anticonvulsants, clonidine, stimulants, SSRIs and SNRIs. Librium, Limbitrol are a few of the medications frequently prescribed. They are used to treat symptoms of acute anxiety. They can be habit-forming and should be used for short-term therapy. Many ignore the caution about short-term use and unfortunately end up being seriously addicted to the drug. Never self-medicate and always be under the care of a physician.

Use of Propranolol as an off-label treatment for anxiety

Ask your doctor about using beta blockers such as propranolol to reduce nervousness and tremors. It is important to use the medication exactly as your doctor has prescribed it. Never self-medicate and always be under the care of a physician.

Propranolol is a well-known beta blocker used for the treatment of high blood pressure. There are newer beta blockers that have entered the market and these have more selective actions and in general are more efficacious. Propranolol is still however widely prescribed by doctors for the treatment of the conditions previously listed. Propranolol has been gaining popularity for the treatment of physical symptoms which result from anxiety. It has been effectively used to treat “performance anxiety”.

Important tips for using over-the-counter medicines for anxiety:

  • The printed directions and warnings must be adhered to. Pay attention to the dosage and frequency with which the medication should be taken.
  • Discuss OTC medications with the doctor or nurse. Give the names of any other medication which you may also be taking.
  • Check the label for the list of ingredients. A rule of thumb is to choose products that have fewer items listed.
  • Avoid buying OTC medications which are close to the expiration dates. Drugs become less effective over time and should be replaced.
  • Keep all OTC medicines out of the reach of children. Store medicinesin a cool, dry area.
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A Word of Caution

Women who are planning to get pregnant, pregnant or breastfeeding should talk to their provider before taking any OTC medicine.

Special care should be taken when giving children and older adults an OTC medication. Always ask the pharmacist if the medication is safe for use by the very young and elderly. People in these age groups should take special care when taking over-the-counter medicines.

Discuss the use of OTC medication with your provider when:

  • Your symptoms are severe or prolonged.
  • You are not at all sure what is really wrong with you.
  • You have a chronic illness for which you are taking prescription medicines.
  • You are unsure of the dosage for a child or the elderly

Alternatives to Medication: Natural remedies

There are herbal teas that have a calming effect such as chamomile and valerian.

Chamomile

Common Names:  chamomile, German chamomile

Chamomile has been widely used in children and adults for thousands of years for a variety of health conditions. Today, chamomile is used as a folk or traditional remedy for sleeplessness, anxiety, and gastrointestinal conditions such as upset stomach, gas, and diarrhea. It is also used topically for skin conditions and for mouth ulcers resulting from cancer treatment.

The flowering tops of the chamomile plant are used to make teas, liquid extracts, capsules, or tablets. The herb can also be applied to the skin as a cream or an ointment, or used as a mouth rinse.

What the Science Reveals

  • There are not many clinical studies on chamomile.
  • In combination with other herbs, chamomile may be of some benefit for upset stomach, for diarrhea in children, and for infants with colic.
  • NCCIH-funded research includes studies of chamomile for generalized anxiety disorder and abdominal pain caused by children’s bowel disorders.

Side Effects and Cautions

  • There are reports of some person’s having allergic reactions to chamomile products. Reactions can include skin rashes, throat swelling, shortness of breath, and a life-threatening allergic reaction called anaphylaxis.
  • Persons who are allergic to ragweed, chrysanthemums, marigolds, and daisies are likely to also be allergic to chamomile.
  • Herbs can cause adverse reactions with prescribe meds. It is always a safe practice to tell your doctor if you are using chamomile. Tell all your health care providers about any complementary health approaches you use. This will help to ensure your safe care.

Valerian Root

Common Names:  valerian, all-heal, garden heliotrope

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Valerian is used as a traditional remedy for sleep disorders and anxiety, as well as headaches, depression, irregular heartbeat, and trembling.

The roots and rhizomes (underground stems) of valerian are typically used to make supplements, including capsules, tablets, and liquid extracts, as well as teas.

What the Science Reveals

  • There is not enough scientific evidence to determine whether valerian works for other conditions, such as anxiety or depression.
  • Research suggests that valerian may be helpful for insomnia, but there is not enough evidence from well-designed studies to confirm this.
  • NCCIH-funded research on valerian includes studies on the herb’s effects on sleep in healthy older adults and in people with Parkinson’s disease. NCCIH-funded researchers are also studying the potential of valerian and other herbal products to relieve menopausal symptoms.

Side Effects and Cautions

  • No information is available about the long-term safety of valerian.
  • Valerian can cause mild side effects, such as tiredness the morning after its use, headaches, dizziness, and upset stomach.
  • Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

If you are thinking about using an herbal medicine, first get information on it from reliable sources. Make sure to tell your health care provider about any herbal medicines you are taking.

-Written by a doctor for Khemcorp

References

  1. Anxiolytics, Pietrangelo Ann. http://www.healthline.com/health/anxiolytics
  2. Anxiolytics, Benzodiazepines. Medscape reference. Reference.medscape.com.
  3. Anxiety Disorders– Guide to the different types of anxiety disorders, their symptoms, and how to get help. (National Institute of Mental Health)
  4. Anxiety & Panic Attacks Symptoms– Extensive list of the signs and symptoms of anxiety disorders and anxiety attacks. (National Panic & Anxiety Disorder News)
  5. Treatment options for anxiety attacks and anxiety disorders
  6. Anxiety Treatment Options– Article looks at the many treatment options for anxiety, including exercise and breathing techniques. (Better Health Channel)
  7. What are the Psychotherapeutic and Other Non-Drug Approaches to Anxiety Disorder?– Overview of therapies and complementary treatments for anxiety. (University of Maryland Medical Center)
  8. Complementary treatments for anxiety attacks and anxiety disorders
  9. Progressive Muscle Relaxation– Step by step guide to progressive muscle relaxation for the reduction of anxiety. (A Guide to Psychology and its Practice)
  • NIH: National Center for Complementary and Integrative Health