What are the Treatment Options for Anxiety?

Medication Therapy

SSRIs

• Newer antidepressants such as SSRIs are typically the first medication used.
• All of these medications have been shown to be helpful for one or more anxiety disorder.
•  For patients with anxiety attacks, very low dosages should be used at first, as there is evidence that these medications can actually increase attacks when first started at higher dosages.
• An added benefit of using SSRIs is that they can also help with the depression that often goes along with the anxiety.

Benzodiazepines

Benzodiazepines should be used with caution in older patients with PD or in those with dementia. If used regularly, they should never be stopped suddenly to avoid serious withdrawal symptoms.

• An older class of medications called benzodiazepines is used to treat anxiety disorders and target the brain chemical GABA.
• Most of these medications have been around for many years including:

• diazepam (Valium®)
• lorazepam (Ativan®)
• clonazepam (Klonopin®)
• alprazolam (Xanax®)

• They can be very effective for anxiety, sometimes working better than antidepressants.
• They take effect very quickly, often providing some relief after a single dose, though they have to be taken regularly for a lasting effect.
• These medications can also help with other symptoms of PD, including certain types of tremor, muscle cramping and sleep changes.
• Major drawbacks of using benzodiazepines include memory difficulties, confusion, increase in balance problems and tiredness.
• These medications should not be stopped suddenly once they have been taken regularly, as patients can have uncomfortable and serious withdrawal symptoms.

Medical content reviewed by: Nina Browner, MD—Medical Director of the NPF Center of Excellence at the University of North Carolina at Chapel Hill in North Carolina and by Fernando Pagan, MD—Medical Director of the NPF Center of Excellence at Georgetown University Hospital in Washington, D.C.

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