Taming Your Worries
The medications we have developed to treat toxic forms of worry mark a major breakthrough in healing human distress. While we must take care not to overuse medications, I am glad we have the option of using them when necessary. Listen to what my patient Jane wrote me, after she began taking Prozac: "My response to Prozac was dramatic. Within several weeks I stopped feeling depressed. I did not, however, expect that I would also stop worrying, but I did. I began to expect that problems would be resolved, and I resolved them." Psychotherapy, a program of exercise, and Prozac were the solutions to a lifetime problem for Jane.
We now have many safe and effective medications to treat worry:
Benzodiazepines, such as Valium, are the most common group of medications used to treat anxiety and worry. They shut down the alarm system in the brain, but can be habit-forming, even addictive, and some interact dangerously with alcohol. They are used best as part of a short-term intervention.
Beta-blockers, such as Propranolol (Inderal) can be useful for worry associated with specific situations, such as stage fright, or fear of public speaking. Taking a low dose an hour or so before a performance or speech can curtail tremor, palpitations, and sweating. Beta-blockers have some side effects, and cannot be used in people who have asthma.
Buspirone (BuSpar) is a new antianxiety agent that does not seem sedating or addictive—but is also less potent than benzodiazepenes.
Antidepressants play an important role in the treatment of worry. By far the most famous antidepressants are the selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Zoloft. For people who brood endlessly, an SSRI can break the cycle. This change is not mind-altering so much as it is mind-healing. Ruminations are like severe headaches. If they go away, you feel like a new person, although you are in fact no different at all. You are the healthy version of yourself. The SSRIs have also become the first choice in panic disorder, and can help OCD. An older antidepressant, Chlomipramine (Anafranil) is still the first choice for OCD, but its side effects are worse.
Wellbutrin is an unusual antidepressant that increases two neurotransmitters, dopamine and norepinephrine. It's a good choice for worry that is associated with depression.
MAO Inhibitors such as Nardil require dietary changes (users must avoid wine, cheese, and chocolate) but are very effective for worry tied to a fear of rejection, or to post-traumatic stress.
We now have many safe and effective medications to treat worry:
Benzodiazepines, such as Valium, are the most common group of medications used to treat anxiety and worry. They shut down the alarm system in the brain, but can be habit-forming, even addictive, and some interact dangerously with alcohol. They are used best as part of a short-term intervention.
Beta-blockers, such as Propranolol (Inderal) can be useful for worry associated with specific situations, such as stage fright, or fear of public speaking. Taking a low dose an hour or so before a performance or speech can curtail tremor, palpitations, and sweating. Beta-blockers have some side effects, and cannot be used in people who have asthma.
Buspirone (BuSpar) is a new antianxiety agent that does not seem sedating or addictive—but is also less potent than benzodiazepenes.
Antidepressants play an important role in the treatment of worry. By far the most famous antidepressants are the selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Zoloft. For people who brood endlessly, an SSRI can break the cycle. This change is not mind-altering so much as it is mind-healing. Ruminations are like severe headaches. If they go away, you feel like a new person, although you are in fact no different at all. You are the healthy version of yourself. The SSRIs have also become the first choice in panic disorder, and can help OCD. An older antidepressant, Chlomipramine (Anafranil) is still the first choice for OCD, but its side effects are worse.
Wellbutrin is an unusual antidepressant that increases two neurotransmitters, dopamine and norepinephrine. It's a good choice for worry that is associated with depression.
MAO Inhibitors such as Nardil require dietary changes (users must avoid wine, cheese, and chocolate) but are very effective for worry tied to a fear of rejection, or to post-traumatic stress.
This entry was posted by Mandy, on
Wednesday, May 13, 2009.
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