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Anxiety Treatments and Drugs

The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you.

Psychotherapy

Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. It can be an effective treatment for generalized anxiety disorder.

Cognitive behavioral therapy is one of the most effective forms of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.

Medications

Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects.

  • Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) classes, are the first-line medication treatments. Examples of antidepressants used to treat anxiety disorders include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants.

  • 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.

  • In limited circumstances, your doctor may prescribe one of these sedatives for relief of anxiety symptoms. Examples include alprazolam (Niravam, Xanax), chlordiazepoxide (Librium), 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.

While most people with anxiety disorders need psychotherapy or medications to get anxiety under control, lifestyle changes also can make a difference. Here's what you can do:

  • Keep physically active. Develop a routine so that you're physically active most days of the week. Exercise is a powerful stress reducer. It may improve your mood and help you stay healthy. Start out slowly and gradually increase the amount and intensity of your activities.

  • Avoid alcohol and other sedatives. These substances can worsen anxiety.

  • Quit smoking and cut back or quit drinking coffee. Both nicotine and caffeine can worsen anxiety.

  • Use relaxation techniques. Visualization techniques, meditation and yoga are examples of relaxation techniques that can ease anxiety.

  • Make sleep a priority. Do what you can to make sure you're getting enough sleep to feel rested. If you aren't sleeping well, see your doctor.

  • Eat healthy. Healthy eating — such as focusing on vegetables, fruits, whole grains and fish — may be linked to reduced anxiety, but more research is needed

Some people are interested in trying alternative medicine (a nonconventional approach instead of conventional medicine) or complementary medicine (a nonconventional approach used along with conventional medicine).

Several herbal remedies have been studied as a treatment for anxiety, such as those listed below, but more research is needed to fully understand the risks and benefits. Here's what researchers know — and don't know:

  • Kava appeared to be a promising treatment for anxiety, but reports of serious liver damage — even with short-term use — caused several European countries and Canada to pull it off the market. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using kava until more rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.

  • In some studies, people who used valerian reported less anxiety and stress, but in other studies, people reported no benefit. Discuss valerian with your doctor before trying it. While it's generally well-tolerated, there are a few case reports of people developing liver problems when taking preparations containing valerian. If you've been using valerian for a long time and want to stop using it, many authorities recommend that its use be tapered down to prevent withdrawal symptoms.

  • A few small clinical trials suggest that passionflower might help with anxiety. In many commercial products, passionflower is combined with other herbs, making it difficult to distinguish the unique qualities of each herb. Passionflower is generally considered safe when taken as directed, but some studies have found it can cause drowsiness, dizziness and confusion.

  • This amino acid is found in green tea and may be found in some supplements. Preliminary evidence shows that theanine may make some people feel calmer, but there is limited evidence that it helps treat anxiety.

Before taking herbal remedies or supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.