Some of these over the counter medications will have an anti-anxiety effect, but just because they are freely available it doesn’t mean that it is safe or advisable to use them regularly.
Some people find that pain relievers like co-codamol, which contains the opiate codeine, relieves anxiety. You should be cautious about taking co-codamol regularly as it could be habit forming (although the opiate dose is quite low).
Also, with anti-anxiety drugs it can be tempting to take more and more as the effect becomes weaker the longer you take it. Overdosing on co-codamol can be fatal or cause serious and permanent organ damage.
The same can be said of over-the-counter sleep aids which often contain antihistamines which may have a small anti-anxiety effect. The fact is that they tend to stop working if you use them too often and any effect you get from them is likely to be quite small. They are probably safer than an opiate-containing analgesic.
There is one drug that is, occasionally, prescribed for anxiety but is also available in a slightly different form over the counter in many countries. Prochlorperazine is normally prescribed for vertigo and nausea and vomiting however at a higher dose it can be used for anxiety (although rarely is!).
Prochlorperazine is available over the counter under the name Buccastem. It is sold in a low dose, just 3mg, in a quickly absorbed under-the-tongue pill.
The problem is that if a doctor were to prescribe Prochlorperazine for anxiety the dose would be much higher. That means that you would have to take more than twice as much as the label recommends, something which I do not recommend and have certainly never tried myself.
All in all, you might get some anti-anxiety effect from an over the counter pill but it’s probably best to speak to your doctor about something more suitable or try a natural approach or read Anxiety Disorders Herbal Remedies.
Whatever you do, don’t be tempted to buy anything from an online pharmacy – the prices are ridiculous and the quality is dubious.
Let’s look at the range of medication available for anxiety symptoms. But before we do that, we should remind ourselves that taking medication for anxiety just treats the symptoms temporarily and does not effect the cause or provide any kind of long term solution (unless of course you take the medication long term).
Plenty of people do find the current anti-anxiety medication effective. Doctors normally turn to SSRI’s to fight anxiety. The have both pros and cons. In their favour they tend to work reasonably well with most patients managing to cope with their symptoms much better.
On the downside the side-effect profile is rather bad. Many people suffer from an increase in symptoms in the first instance and also nightmares, sweating, mood swings and lethargy or fatigue. And long-term there is the issue of weight gain, which can also be a big problem.
Also read this post on Anxiety Medication Over The Counter.
There are also benzodiazepine tranquillizers such as Xanax and Valium. These are very effective short-term remedies but they may leave you too “stoned” to function properly. Worse still, if you take them long then addiction and habit formation is a big problem. Read this post on rebound anxiety for more.
There are other drugs like Buspirone which promised much and takes the centre ground between SSRI’s and benzodiazepine tranquillisers. In reality it is not much better than the others but might be worth a try if you really want long-term medication but can’t take the SSRI’s.
It is much better to find other ways to tackle anxiety though, as ultimately medication doesn’t achieve lasting change alone.
There are now a whole range of drugs for panic attacks on the market. For all of these drugs you will need a doctor’s prescription; none of them are available over the counter. All of these drugs have pros and cons, and some have serious side-effects.
The most effective Panic Attack Drug I have ever come across is Xanax (generic name: alprazolam). It works super-fast (in as little as twenty minutes if it is taken sub-lingually, or under the tongue). It is a benzodiazepine class drug, but unlike the others I have tried it doesn’t make you feel spacey, drunk, “out of it” or lethargic and sleepy. On Xanax I feel fairly normal, although I did once fall asleep on a large dose.
Xanax does have its drawbacks though. If you take it when you are having the occasional panic attack then that will probably be fine. But if you are a regular sufferer then Xanax might not be wise. While it’s side-effect profile is good, any prolonged use (more than a week or two of even small doses such as 0.5mg a day) can become habit forming. Being hooked on Xanax is not fun. It can lead to severe rebound anxiety and a host of other problems. Xanax carries a greater risk of rebound anxiety than other tranquillisers and benzodiazepines because it has a short half-life. The other drugs with their longer half-life are in a way “self tapering”.
Clonazepam, Diazepam (Valium), Lorazepam (Ativan) all have significantly longer half-lives than Xanax and therefore are less habit-forming (but that does not mean that they are totally safe – addiction is still common!)
Side-effects include drowsiness and amnesia. Some people get paradoxical effects, in other words the opposite reaction to what they expected. In the case of someone taking these drugs for panic attacks that would be heightened excitement and possible anxiey and panic attacks! Therefore it is useful to start at a low dose and see how the drugs work for you. Some people don’t like using benzodiazepines because they feel out of control because they are so used to feeling anxious and panicky.
There are newer tranquillisers known as Nonbenzodiazepines, but their side-effect profile is no better and at the moment they are used chiefly for insomnia, not for panic attacks.
All in all, it’s important to remember that drugs don’t provide an overall solution to panic attacks but are fine for occasional use.
Xanax (alprazolam), like other benzodiazepines, is famous for its rebound anxiety – the anxiety that you can get after you stop taking a drug or as the effects of the drug wear off.
With Xanax you can get a rebound effect just from taking the drug once. It is in essence a bit like a hangover. People have reported different symptoms and plenty of people don’t get any rebound anxiety from just taking xanax once or only occasionally. Some of the symptoms people have reported from Xanax come-down are:
- Feeling Groggy/Spacey
- Lacking Motivation
- Feeling Lazy
- Feeling Anxious
- Having a Headache
This straight-forward Xanax hangover tends to be mild and pass over the course of the day.
Much more unpleasant and persistent is the rebound anxiety that you can get after you have been taking Xanax for some time (normally at least 2 weeks but less for some people). For an explanation of why rebound anxiety happens please click here.
Some common symptoms of rebound anxiety from Xanax:
- Palpitations (racing heart)
- Panic Attacks
- Intense feeling of fear
- Tight chest and difficulty breathing
- Upset stomach
- Aching Muscles
Rebound anxiety is often described as much much worse than the anxiety that lead the patient to take Xanax in the first place. It can be very serious and that is why you should never stop Xanax abruptly and always follow the doctor’s advice!
If you are suffering from rebound anxiety then speak to a doctor and talk about tapering your dose. Else you can be in for a miserable few weeks or months, as rebound anxiety can really go on (length of rebound anxiety seems to depend on amount of time you were taking Xanax, size of dose and personal differences).
Remember, drugs are not the answer to anxiety. If you are interested in permanent solutions to anxiety I recommend reading Killing Anxiety From The Roots, which is all about the underlying physical causes of anxiety.
You might also consider reading our Panic Away Review.
Rebound Anxiety is anxiety that is caused by stopping taking some form of medication. It is most common to get rebound anxiety from tranquilisers such as benzodiazepines (see Does Xanax Work for Anxiety) and also anti-depressant SSRI’s such as Prozac and Celexa.
Rebound anxiety is thought to be caused by the fact that many drugs (including benzodiazepines and SSRI’s) achieve their goal by fooling the brain into believing that levels of certain brain chemicals are higher than they really are. The brain then cuts down on its own production of said chemicals leaving you deficient unless you keep taking the drugs.
The answer is to not get hooked in the first place. But failing that, it is best to withdraw slowly, to taper off from the drugs. This will allow your body to compensate by making more and more of its own chemicals.
That is why medication alone is never the answer to anxiety and panic attacks, only a symptomatic cure and one with major downsides.
Seredyn is an anxiety treatment that can be obtained without prescription. It includes none of the chemicals you would associate with other anxiety medications such as SSRI’s and Benzodiazepines. But Seredyn does claim to have much the same effects – a reduction in anxiety.
So what exactly is Seredyn? Well, as far as we know it is a blend of Valerian Root, Passion Flower and Suntheanine. Suntheanine is a registered trademark version of the amino acid L-theanine that I have blogged about before. L-theanine is basically a key ingredient of GABA, which when taken promotes anxiety relief in the same way as a Benzodiazepine such as Xanax.
Both Valerian Root and Passion Flower (Passiflora) have been used as stress-relievers and anxiety cures for countless years.
Although the ingredients are clear, the actual amount of each ingredient is not clear. Some say this is because Seredyn want to protect their intellectual property (after all, Valerian Root, Passiflora and L-theanine are available in pretty much any self-respecting health food store). Other, more cynical, people say that Seredyn doesn’t contain enough of each ingredient to be effective.
As products like Seredyn don’t need to be licensed in the same way as new drugs do, there will never be extensive, peer reviewed, clinical research. I guess that means you either take advice from people you trust, or try it yourself and see if it works.
Also read this post on other anxiety treatments. And if you are interested in Seredyn you might also be interested in other herbs for anxiety.
Elsewhere on the Internet people have said you should watch Seredyn if you have low blood pressure, as it can supposedly exacerbate the problem. I don’t know if that’s true or not, but basically there isn’t much else in there that’s likely to do the normal person any harm!
Also read: Anxiety Disorder Herbal Remedies
Xanax, also known by the generic name Alprazolam, has been licensed in the USA to treat anxiety and panic attacks since 1981. It is used in the treatment of anxiety disorders, panic disorder and, in some cases, depression. It is a member of a family of drugs known as Benzodiazepines. It is a mild tranquilizer.
Many people who have experienced drugs like Valium may be aware of how Benzodiazepines can make you feel doped and sleepy. Xanax is not like this for many people. In my own personal experience Xanax didn’t make me feel very different at all, just much much calmer. I didn’t get any of the side effects listed, and in an ad hoc experiment to see how my reaction times were effected I actually found my reactions to be almost exactly as good as when I wasn’t on Xanax.
Some people do suffer from side effects, sleepiness, dizziness and vertigo, nausea. But these drugs are rather well-tolerated.
In terms of dose, it is important to follow your doctor’s instructions. I personally worked my way up from the 0.25mg dose which is the lowest available and now take 1.5mg on an as needed basis.
Initially I took a tiny amount of one Xanax tablet to see how I tolerated it. As I was fine I took the rest. Some people who suffer from anxiety may have a psychosomatic side effect of feeling a sudden onset of anxiety or panic whenever they try something new. This can mean that at first a Benzodiazepine has a paradoxical effect. If I were you I would persevere, as for the short term relief of temporary anxiety and panic attacks this drug is very useful and very effective.
A word of caution. Like all Benzodiazepines, Xanax can be habit forming. If you take it for too long you may need to taper off slowly to avoid withdrawal effects. Also, if you take it often you may find you need to take more to get the same effect. Your doctor will be able to advise you on this.
I don’t recommend you buy from online pharmacies without prescription, you don’t know what you are getting or how safe it is, or even if it will arrive or not!
Xanax for travel anxiety.
There is lots of medication for anxiety available on the market. Almost all of it is only available on prescription from a doctor.
Normally, Patients presenting with anxiety are offered Selective Serotonin Re-uptake Inhibitors (SSRI for short). This family of medication is considered suitable if the anxiety disorder is ongoing, as SSRI’s are not suitable for short term use. They tend to take at least four weeks to start working (although some people claim to feel better in as little as two days) and aren’t thought to be fully effective until they have been taken for 6 weeks to two months. The common SSRI’s are:
- citalopram (Celexa, Cipramil, Celepram, Emocal, Sepram, Seropram)
- escitalopram (Lexapro, Cipralex, Esertia, Esipram)
- fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Fluctin [EUR])
- paroxetine (Paxil, Seroxat, Aropax, Deroxat, Paroxat)
- sertraline (Zoloft, Lustral, Serlain)
- venlafaxine (Effexor) (SNRI)
- duloxetine (Cymbalta)
- dapoxetine (Priligy)
- fluvoxamine (Luvox, Faverin, Favoxil)
Other drugs which might also be prescribed and are similar to SSRI’s are SNRI’s or Serotonin-norepinephrine Reuptake Inhibitors. The most commonly prescribed SNRI is Venlafaxine (Effexor). SNRI’s are newer than SSRI’s and tend to be slightly better tolerated with fewer side effects. They were designed to treat depression but are also a medication for anxiety. Likewise they are prescribed for long term use, normally six months or more and sometimes years.
Also read this post on Anxiety Medication Over The Counter.
If a medication for anxiety which is short term is needed then there are various other options. In times of extreme grief or pain, or when panic attacks are severe, a short acting anxiolytic might be used. The normal choice would be one of the Benzodiazepine family:
- Xanax, alprazolam:
- Lexotan, bromazepam:
- Librium, chlordiazepoxide:
- Klonopin, clonazepam:
- Tranxene, clorazepate:
- Valium, diazepam:
- Rohypnol, flunitrazepam:
- ProSom, estazolam:
- Dalmane, flurazepam:
- Paxipam, halazepam:
- Dormonoct, loprazolam:
- Ativan, lorazepam:
- Versed (Hypnovel, Dormicum), midazolam:
- Mogadon, nitrazepam:
- Serax, oxazepam:
- Doral, quazepam:
- Restoril, temazepam:
- Halcion, triazolam:
Benzodiazepines are good because they work quickly (less than an hour even) and are very good at what they do – stopping anxiety and panic. In a way they are the ultimate medication for anxiety. The problem is that if they are taken for too long they become less effective and can become addictive. Constant use for more then three weeks is rarely advised. For a personal experience of Valium click here.
Another drug that is not a Benzodiazepine is Buspirone, which is said to be as good as a Benzodiazipine for reducing anxiety but non-addictive and non-sedating. It has a better side-effect profile but can not be taken on an as needed basis. It has to be taken daily and takes two or three weeks to take effect. As it is non-addictive it is much better suited to long-term use Benzodiazepines.
Treatment for Panic Attacks in mainstream medicine revolves around two things: medication and CBT (Cognitive Behavior Therapy).
Medication tends to fall into two categories: SSRI’s and Benzodiazepines.
The SSRI’s, like prozac, celexa, zoloft etc have pros and cons. They are clinically proven to be effective (although all data from big pharma companies has been called in question at sometime or other). Unfortunately they do have side-effects of which weight gain, nausea (normally temporarily) and sexual dysfunction/loss of libido (normally temporary) are the most severe and commonly reported. SSRI’s normally take 4-6 weeks to start working and may need to be tapered off slowly at the end of treatment.
Benzodiazepines, like Xanax alprazolam and valium also have pros and cons. They are fast working, normally taking considerably less than an hour to kick in, and are extremely effective. On the downside they can be highly addictive and therefore are not best suited to long term use (although they are prescribed long term sometimes). They also can effect concentration and alertness so hinder the consumer’s ability to drive for example.
On the CBT front, over ten or twelve sessions a trained therapist will help you see panic attacks for what they are (harmless natural responses which appear nasty), will show you how to rationalize out the faulty and extreme negative thinking which causes panic attacks, and show you some physical techniques to calm your breathing and relax your mind and body.
Some people argue that CBT doesn’t really get to the heart of the problem, that you need some kind of psychotherapy to do that. Others argue psychotherapy is a pointless and long-winded waste of money.
Often a combination of therapy and drugs work best.
There are other potential treatments for panic attacks involving herbs and supplements like 5-htp which many people swear by. It should be noted that the effects of long term use of these other therapies has not bee fully studied.
Lots of people have had weight gain problems with Celexa (citalopram) and Cipralex/Lexapro (escitalopram). Indeed most psychotropic drugs can potentially cause weight gain.
Advice for avoiding weight gain.
Firstly let’s cover the basics: try to eat well, make sure you eat whole foods, complex carbohydrates and keep refined sugars and processed fats to a minimum. Also, take plenty of exercise. Whether you are taking an SSRI for depression, panic attacks or anxiety, you are almost guaranteed to feel better to some extent just by exercising. It also of course keeps weight off.
Now the clever part: One hour or so before meals it a high carbohydrate snack. This could be some fruit, some oatcakes, even high cocoa content chocolate. Don’t eat too much, say a couple of hundred calories, and try to eat something that isn’t too refined, so your body burns it slowly.
You should then find that this carbohydrate snack has boosted the Serotonin levels in your brain and that this will limit your food cravings. (click here to understand why carbohydrates boost Serotonin levels.) Your appetite will return to more reasonable levels and you should keep/gain control of your weight. Worth a try anyway!