Munson Health
 
Medications for Generalized Anxiety Disorder (GAD)

Back to Document

by Scholten A
 
The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Generalized anxiety disorder (GAD) has a biological component. Abnormal amounts of certain brain chemicals may play a role in its development. The condition often responds to medication. Anxiolytics (anti-anxiety medications) and antidepressants help ease the symptoms of anxiety. They are often used in combination with counseling, such as cognitive-behavioral therapy.
Depending on your situation, medication may be advised for the short-term or for a lengthy period of time. In general, people who are treated for a longer period of time usually have a lower relapse rate. Medication will likely be recommended if anxiety impairs your ability to function.

Prescription Medications

  • Buspirone
  • Lorazepam
  • Prazepam
  • Flurazepam
  • Clonazepam
  • Triazolam
  • Chlordiazepoxide
  • Halazepam
  • Temazepam
  • Oxazepam
  • Clorazepate
  • Diazepam
  • Alprazolam
  • Citalopram
  • Fluvoxamine
  • Paroxetine
  • Fluoxetine
  • Sertraline
  • Escitalopram
  • Imipramine
  • Nortriptyline
  • Trazodone
  • Venlafaxine
  • Nefazodone

Prescription Medications

  Azapirones
Common name: Buspirone
Do not take buspirone with monoamine oxidase (MAO) inhibitors. Do not take with alcohol or other sedating drugs. Use with caution if you have liver or kidney disease.
Possible side effects include:
  • Excitability, nervousness
  • Headache
  • Nausea
  • Dizziness
  Benzodiazepines
Common names include:
  • Lorazepam
  • Prazepam
  • Flurazepam
  • Clonazepam
  • Triazolam
  • Chlordiazepoxide
  • Halazepam
  • Temazepam
  • Oxazepam
  • Clorazepate
  • Diazepam
  • Alprazolam
Benzodiazepines reduce symptoms of anxiety by enhancing the function of gamma aminobutyric acid (GABA), a neurotransmitter thought to be abnormal in people with GAD. These drugs produce a sedative effect, reduce physical symptoms, such as muscle tension, and often cause drowsiness and lethargy.
Benzodiazepines are fast acting and useful for treating acute anxiety and insomnia. These drugs can be habit-forming when used long-term or in excess. They may cause withdrawal symptoms, such as anxiety, irritability, and insomnia when discontinued. In such cases, you should taper off the medication slowly, over a period of weeks or months under a doctor’s supervision.
Withdrawal from benzodiazepines can be severe at times. It can include restlessness, tremors, delirium tremens, and seizures that can be life threatening. Dangerously high fever, confusion, hallucinations, and dehydration may also occur. Benzodiazepines should not be used for more than four weeks. GAD may return after stopping the drug, but that is often true of any medication or treatment. Talk to your doctor before changing how you take this medication.
Do not take with alcohol or other sedating drugs. Do not take if you must drive a vehicle or operate machinery. Benzodiazepines should not be taken in combination with certain oral antifungal medications or by people with certain types of glaucoma.
Possible side effects include:
  • Drowsiness or lethargy
  • Confusion
  • Dizziness, particularly in elderly persons
  • Slow reaction time, impaired coordination
  • Memory changes
  Tricyclic Antidepressants
Common names include:
  • Imipramine
  • Nortriptyline
Tricyclic antidepressants are thought to regulate serotonin and norepinephrine in the brain. They have been used effectively for the treatment of depression. Improvement is usually seen in three to six weeks after beginning treatment. These drugs are highly toxic if taken in large doses; therefore, they are often not prescribed for suicidal patients. Tricyclic antidepressants are not addictive. These drugs are infrequently used for the treatment of GAD because of the many side effects, plus the overdose potential.
Possible side effects include:
  • Dizziness
  • Dry mouth
  • Constipation
  • Difficulty urinating
  • Weight gain
  • Low blood pressure
  • Sexual dysfunction
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients (Young adults may be at a higher risk for this side effect.)
 

References


Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Published August 22, 2010. Accessed December 28, 2012.


Generalized anxiety disorder (GAD). EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated December 5, 2012. Accessed December 28, 2012.


General Anxiety. Family Doctor.org website. Available at: http://familydoctor.org/online/famdocen/home/common/mentalhealth/anxiety/013.html. Updated November 2010. Accessed December 28, 2012.


Fricchione G. Generalized anxiety disorder. N Engl J Med. 2004;351:675-682.


Generalized anxiety disorder (GAD). Anxiety Disorders Association of America website. Available at: http://www.adaa.org/finding-help/treatment/medication. Accessed December 28, 2012.


Stern T, Rosenbaum J, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. Philadelphia, PA: Mosby Elsevier; 2008.


2/18/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

 

Revision Information