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Treatments and drugs

By Mayo Clinic staff

When anxiety is severe, disrupts your day-to-day life, causes panic attacks or doesn't get better over time, you may have a disorder that needs to be diagnosed and treated.

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.

Psychotherapy
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.

Medications
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.

  • 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.
Lifestyle and home remedies Tests and diagnosis
References
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  10. Kava linked to liver damage. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/news/alerts/kava. Accessed May 24, 2012.
  11. 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.
  12. Jacka FN, et al. Association of Western and traditional diets with depression and anxiety in women. American Journal of Psychiatry. 2010;167:305.
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  14. Valerian. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/valerian. Accessed June 5, 2012.
  15. 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.
  16. Support & programs. National Alliance on Mental Illness. http://www.nami.org/Template.cfm?section=Find_Support. Accessed June 5, 2012.
  17. Getting support. Anxiety and Depression Association of America. http://www.adaa.org/finding-help/getting-support. Accessed June 5, 2012.
DS01187 June 30, 2012

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