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medication for stress relief

What Medication Can I Take for Stress and Anxiety?

In the grand scheme of things, stress and anxiety might just be your body’s overzealous way of preparing you for that bear attack that’ll probably never happen. But when these feelings start to interfere with your daily life, you might find yourself looking for a solution in a pill bottle.

Before you start popping anything, it’s vital you chat with your healthcare provider. They can guide you through the maze of options – from SSRIs and SNRIs to benzodiazepines, and even the less commonly discussed alternatives like beta-blockers or kratom. Each medication has its own profile of benefits and potential side effects, and what works wonders for one person might not be the best fit for you.

Your journey to finding the right medication is just as unique as you are, and with professional guidance, you’re one step closer to reclaiming your calm. What Medication Can I Take for Stress and Anxiety? Stay tuned to uncover more about how these options could fit into your life.

Key Takeaways

  • Benzodiazepines provide quick relief for anxiety but carry risks of tolerance and dependency.
  • SSRIs and SNRIs are safer long-term options for managing anxiety symptoms.
  • Buspirone and beta-blockers offer non-habit-forming alternatives with fewer side effects.
  • Consultation with healthcare providers is crucial for choosing the right medication and dosage.

Benzodiazepines

sedative medications for anxiety

What medication can I take for stress and anxiety? Benzodiazepines are a class of psychoactive drugs that act as central nervous system depressants, or sedatives and tranquilizers. They are used primarily for their anxiolytic (anti-anxiety), anticonvulsant, muscle relaxant, and hypnotic (sleep-inducing) effects. Benzodiazepines work by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA_A receptor, leading to sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties.

Commonly prescribed benzodiazepines include alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), and clonazepam (Klonopin). These medications are usually prescribed for short-term management of anxiety disorders, insomnia, acute seizure episodes, and muscle spasms. They are also used as premedication before certain medical procedures.

Despite their therapeutic benefits, benzodiazepines have potential for abuse, dependence, and withdrawal symptoms. Long-term use can lead to tolerance (needing more of the drug to achieve the same effect) and physical dependence, making it difficult to discontinue use. Withdrawal symptoms can include anxiety, insomnia, seizures, and other serious problems. Because of these risks, benzodiazepines are generally prescribed for short durations and under close medical supervision.

What Are The Side Effects of Benzodiazepines?

Dependence and withdrawal: Long-term use can lead to physical dependence, and stopping them suddenly can result in withdrawal symptoms.

  • Tolerance: Over time, higher doses may be required to achieve the same therapeutic effects.
  • Drowsiness and sedation: These are common side effects, which can impair the ability to perform tasks that require alertness, such as driving.
  • Cognitive impairment: Memory problems and reduced cognitive function can occur, especially with long-term use.
  • Overdose risk: Especially when combined with other central nervous system depressants like alcohol, opioids, or other sedatives.

Benzodiazepines Dosage Guidelines:

Dosages for benzodiazepines can vary widely depending on the specific medication, its form (e.g., tablet, liquid, injectable), the condition being treated, the patient’s age, weight, and general health, as well as other factors such as tolerance to the medication. Therefore, it’s crucial to follow a healthcare professional’s prescription and guidance closely. Below is a general overview of dosing for a few common benzodiazepines, but this should not be taken as medical advice.

Alprazolam (Xanax)

  • For anxiety: Adults typically start with 0.25 mg to 0.5 mg taken three times daily. The dose may be increased as needed and tolerated but generally does not exceed 4 mg/day.
  • For panic disorder: The initial dose is usually 0.5 mg to 1 mg once daily. The dose may be adjusted as needed, with a usual dose range of 1 mg to 10 mg per day.

Diazepam (Valium)

  • For anxiety and muscle spasms: Adults might take 2 mg to 10 mg two to four times daily.
  • For alcohol withdrawal: The initial dose can be 10 mg three to four times during the first 24 hours, then 5 mg taken three to four times daily as needed.

Lorazepam (Ativan)

  • For anxiety: The initial dose is usually 2 mg to 3 mg/day, given in two or three divided doses.
  • For insomnia due to anxiety or transient situational stress**: A single daily dose of 2 mg to 4 mg may be taken, usually at bedtime.

Clonazepam (Klonopin)

  • For seizures: Adults may start with 0.5 mg three times a day. The dose may be increased by 0.5 mg to 1 mg every three days until seizures are controlled or side effects preclude further increases. The maximum dose is 20 mg/day.
  • For panic disorder: The initial dose is 0.25 mg twice a day. The dose may be increased to the target dose of 1 mg daily after 3 days. [1]

Buspirone

anxiety medication buspirone prescribed

Buspirone is a prescription medication primarily used for treating anxiety disorders, such as generalized anxiety disorder (GAD). Unlike some other medications used for anxiety, such as benzodiazepines, buspirone does not have significant sedative properties and is less likely to cause dependence or withdrawal symptoms. Its mechanism of action is not fully understood, but it’s thought to work by affecting neurotransmitters in the brain, particularly serotonin and dopamine, which play key roles in mood and anxiety regulation.

Buspirone is typically taken orally, and its effects are not immediate; it may take several weeks for patients to experience a reduction in anxiety symptoms. Because of its different mechanism of action and lower risk of dependence, buspirone can be a good option for individuals for whom benzodiazepines are not suitable, such as people with a history of substance abuse. However, like all medications, buspirone can cause side effects, including dizziness, nausea, headache, nervousness, and lightheadedness, among others.

Buspirone must be prescribed by a healthcare provider, who will determine the appropriate dosage based on the patient’s specific circumstances and will monitor the patient’s response to the medication.

What Are The Side Effects of Buspirone?

Common Side Effects:

  • Dizziness
  • Nausea
  • Headache
  • Nervousness
  • Lightheadedness
  • Excitement
  • Insomnia (difficulty sleeping)

Buspirone Dosage Guidelines

Adults (18 years and older)

  • Initial dose: The typical starting dose is 7.5 mg, taken twice a day.
  • Maintenance dose: Depending on the individual’s response and tolerance, the dose may be increased every 2-3 days. The usual dosage range is 15-30 mg per day, divided into two or three doses.
  • Maximum dose: The maximum recommended daily dose should not exceed 60 mg.

Geriatric Patients

Older adults may be started on a lower dose, closely monitored for efficacy and tolerability, and then adjusted as needed. It’s crucial to consider the potential for increased sensitivity to the drug in this population. [2]

Antidepressants

mood altering medication prescribed

Antidepressants are a class of drugs designed to treat depression by alleviating symptoms, improving mood, and restoring chemical imbalances in the brain. Depression is a complex mental health condition characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. It can be caused by a combination of genetic, biological, environmental, and psychological factors. Antidepressants aim to correct imbalances in neurotransmitters—chemical messengers in the brain that affect mood and emotions.

There are several types of antidepressants, each working in different ways and affecting different neurotransmitters. The most commonly prescribed types include:

  1. Selective Serotonin Reuptake Inhibitors (SSRIs): These are typically the first choice due to their relatively mild side effects. SSRIs increase the level of serotonin in the brain, a neurotransmitter that contributes to feelings of well-being and happiness. Examples include fluoxetine (Prozac), sertraline (Zoloft), and citalopram (Celexa).
  2. Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs): These medications increase the levels of serotonin and norepinephrine, another neurotransmitter that plays a key role in mood. Examples include venlafaxine (Effexor XR) and duloxetine (Cymbalta).
  3. Tricyclic Antidepressants (TCAs): Older than SSRIs and SNRIs, TCAs are potent but often have more side effects. They work by blocking the reabsorption of serotonin and norepinephrine. Examples include amitriptyline and nortriptyline (Pamelor).
  4. Monoamine Oxidase Inhibitors (MAOIs): These are used less commonly due to significant side effects and dietary restrictions. MAOIs prevent the breakdown of monoamine neurotransmitters (including serotonin and norepinephrine), thus increasing their levels. Examples include phenelzine (Nardil) and tranylcypromine (Parnate).
  5. Atypical Antidepressants: This category includes medications that don’t fit neatly into the other categories because they work differently. They might affect a mix of neurotransmitters or have unique mechanisms. Examples include bupropion (Wellbutrin), which affects dopamine and norepinephrine, and mirtazapine (Remeron), which increases norepinephrine and serotonin indirectly.

Antidepressants are often effective in treating depression, but they can have side effects ranging from mild (nausea, dry mouth, weight gain) to severe (sexual dysfunction, increased risk of suicide in young adults). Their effectiveness can vary from person to person, and it may take some time to find the most suitable medication and dosage for an individual. They are typically prescribed for at least 6 to 12 months, and in some cases, long-term treatment may be necessary to prevent relapse.

Tricyclics

depression treatment of choice

What medication can I take for stress and anxiety? Tricyclic antidepressants (TCAs) are a class of medications that are used primarily to treat depression, though they have also been found effective in treating a variety of other conditions. They were among the first antidepressants developed and came into use during the 1950s. Despite the development of newer antidepressants with fewer side effects, TCAs are still used for certain cases due to their effectiveness, especially in instances where other medications have failed.

Mechanism of Action

The primary mechanism of action of tricyclic antidepressants involves blocking the reuptake of two neurotransmitters in the brain: serotonin and norepinephrine. This increases the levels of these chemicals in the brain, which is associated with mood elevation and a reduction in depression symptoms. Some TCAs also have affinity for other receptors, including histamine, acetylcholine, and alpha-adrenergic receptors, which can account for some of their side effects.

What Are Tricyclics Side Effects?

Common Side Effects

  • Dry mouth: This is one of the most common side effects.
  • Blurred vision: TCAs can affect your ability to focus your eyes.
  • Constipation: These medications can slow down the movement of the intestines.
  • Urinary retention: Difficulty in urinating due to relaxation of the bladder.
  • Drowsiness: Many people feel drowsy or sedated, which can affect their ability to drive or operate machinery.
  • Dizziness: Especially when standing up too quickly, due to a drop in blood pressure (orthostatic hypotension).
  • Weight gain: Long-term use can lead to an increase in weight.
  • Increased heart rate (tachycardia): This is due to the anticholinergic effects of TCAs.
  • Sweating: Increased or excessive sweating is another possible side effect.

Serious Side Effects

  • Cardiac issues: Including arrhythmias, which are more concerning in individuals with preexisting heart conditions.
  • Seizures: Though rare, seizures are a potential serious side effect, especially at high doses.
  • Severe hypotension: A significant drop in blood pressure.
  • Suicidal thoughts or behavior: As with other antidepressants, especially in young adults and children, there might be an increased risk of suicidal thoughts or behavior.
  • Serotonin syndrome: This is a rare but potentially fatal condition that can occur, particularly if TCAs are taken in combination with other medications that increase serotonin levels.

Tricyclics Dosage Guidelines

  • Depression: For adults, initial doses may vary but often start from 25 mg to 75 mg daily, taken in divided doses or at bedtime to minimize daytime sedation. The dose may be gradually increased based on response and tolerance. The effective dose for most tricyclics is usually in the range of 75 mg to 150 mg daily, though some patients may require up to 300 mg per day in severe cases.
  • Chronic Pain, Migraines, and Neuropathic Pain: Lower doses are often effective for these conditions than for depression. Initial doses may be as low as 10-25 mg at night, with gradual increases to find the effective dose for pain management.
  • Elderly Patients: Older adults are more sensitive to the side effects of tricyclic antidepressants, including dizziness, confusion, and orthostatic hypotension. Lower starting doses (e.g., 10-25 mg at bedtime) and slower dose increases are recommended.
  • Pediatric Use: The use of tricyclic antidepressants in children is less common and requires careful consideration, monitoring, and dosage adjustment based on weight and response. [3]

MAOIs

monoamine oxidase inhibitors details

Monoamine oxidase inhibitors (MAOIs) are a class of medications primarily used to treat depression and, in some cases, anxiety, panic disorders, and certain other psychiatric or neurological conditions. They work by inhibiting the action of an enzyme called monoamine oxidase. This enzyme is responsible for breaking down neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain. By inhibiting this enzyme, MAOIs increase the levels of these neurotransmitters, which can improve mood and alleviate symptoms of depression and anxiety.

MAOIs were among the first types of antidepressants discovered but are no longer the first line of treatment due to their potential side effects and dietary restrictions. They are usually prescribed when other antidepressants have not been effective.

What Are MAOIs Side Effects?

  • Dizziness
  • Headache
  • Drowsiness
  • Insomnia
  • Nausea and gastrointestinal issues
  • High blood pressure, especially if certain foods or other medications are consumed

MAOIs Dosage Guidelines

Phenelzine (Nardil)

  • Initial dose: Typically, the starting dose is 15 mg three times a day.
  • Maintenance dose: The dose may be increased every week or two if needed. The average effective dose is usually between 45 and 90 mg per day, divided into two or three doses.
  • Maximum dose: Should not exceed 90 mg per day.

Tranylcypromine (Parnate)

  • Initial dose: The usual starting dose is 10 mg taken twice a day.
  • Maintenance dose: Depending on the patient’s response, the dosage may be increased every 1 to 2 weeks. The effective dose is usually between 20 and 60 mg per day, divided into two doses.
  • Maximum dose: Should not exceed 60 mg per day.

Isocarboxazid (Marplan)

  • Initial dose: The typical starting dose is 10 mg twice a day.
  • Maintenance dose: The dose may be increased to 20 mg twice a day.
  • Maximum dose: Recommendations suggest not exceeding 60 mg per day.

Selegiline Transdermal Patch (Emsam)

  • Initial dose: The starting dose is usually a 6 mg/24 hr patch applied once a day.
  • Maintenance dose: Depending on the patient’s response, the dosage may be adjusted. Available doses are 6 mg/24 hr, 9 mg/24 hr, and 12 mg/24 hr patches.
  • Maximum dose: The highest available patch is 12 mg/24 hr.

Beta-blockers

control hypertension with beta blockers

Beta-blockers, also known as beta-adrenergic blocking agents, are a class of medications that are primarily used to manage abnormal heart rhythms, and to protect the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention). They work by blocking the effects of epinephrine (adrenaline) and other stress hormones, thus reducing heart rate, the heart’s workload and the heart’s output of blood, which lowers blood pressure.

Mechanism of Action

Beta-blockers work by blocking the beta-adrenergic receptors in the heart and other parts of the body. This action prevents the effects of adrenaline and other stress hormones, leading to a decrease in heart rate, blood pressure, and the strain on the heart.

Types of Beta-Blockers

Beta-blockers can be classified into several types based on their selectivity for beta-adrenergic receptors:

  • Non-selective beta-blockers (e.g., propranolol, sotalol) affect both beta-1 (β1) and beta-2 (β2) receptors throughout the body.
  • Cardioselective beta-blockers (e.g., atenolol, metoprolol) primarily affect β1 receptors, which are mainly located in the heart. They generally have fewer side effects, especially in patients with lung conditions like asthma.
  • Third-generation beta-blockers (e.g., carvedilol, nebivolol) not only block β-adrenergic receptors but also have additional effects such as vasodilation, which can further help in lowering blood pressure.

What Are The Side Effects of Beta-Blockers?

  • Fatigue
  • Cold hands and feet
  • Weight gain
  • Depression
  • Sleep disturbances
  • Sexual dysfunction

Kratom

herbal supplement for anxiety

Kratom, scientifically known as Mitragyna speciosa, is a tropical evergreen tree native to Southeast Asia, particularly found in countries like Thailand, Malaysia, Indonesia, and Papua New Guinea. It belongs to the Rubiaceae family, which also includes the coffee plant. The tree can grow up to 25 meters (about 82 feet) in height, with large green leaves that have been used for centuries by people in its native regions for their psychoactive properties.

The primary active compounds in kratom leaves are mitragynine and 7-α-hydroxymitragynine. These compounds interact with opioid receptors in the brain, producing sedation, pleasure, and decreased pain when taken in high doses. However, at lower doses, it can increase energy, sociability, and alertness instead of sedation.

Kratom is consumed in various ways, including chewing the leaves, brewing them into a tea, grinding them into a powder to be swallowed or mixed with water, and even in the form of tablets or capsules. It has been used traditionally as a stimulant by workers in its native regions, as well as for medicinal purposes to treat various ailments such as pain, diarrhea, and opioid withdrawal symptoms.

What Are Kratom Side Effects?

  • Nausea and vomiting
  • Constipation
  • Loss of appetite
  • Dry mouth
  • Itching
  • Increased urination
  • Dizziness

Kratom Dosage Guidelines

There are no universally accepted dosage guidelines for Kratom due to its unregulated status and the lack of comprehensive scientific research. Dosages can vary significantly depending on the strain, the form (powder, leaves, extract, capsules), and the individual’s body weight, tolerance, and desired effects. Generally, dosage ranges can be categorized as follows:

  • Low dose (1-5 grams): Typically produces stimulant effects, such as increased energy and alertness.
  • Moderate dose (5-15 grams): Can produce opioid-like effects such as pain relief and euphoria, but also increases the risk of side effects.
  • High dose (15+ grams): Increases the risk of severe side effects and is not recommended.

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