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Anxiety Medications (cont.)

Medical Editor:

Are there differences among anxiety medications?

Many anxiety medications work in a similar way , but that does not mean they are interchangeable when it comes to treatment. The SSRIs affect brain serotonin levels. They are useful for treating most types of anxiety. But other antidepressants, including the tricyclics (TCAs) and the monoamine oxidase inhibitors (MAOIs), have more limited use, even though they, too, act on brain serotonin and norepinephrine levels.

The anxiolytics or anti-anxiety drugs, which specifically target these disorders, work in different ways and have specific treatment applications. The benzodiazepines act on the neurotransmitter gamma aminobutyric acid (GABA). Buspirone (BuSpar) enhances the activity of serotonin. The antihistamine hydroxyzine (Atarax, Vistaril), has a sedative effect by blocking certain receptors in the brain.

Medications normally used to treat high blood pressure also have specific off-label uses for treating panic disorders. The beta-blockers propranolol (Inderal) and atenolol (Tenormin) have become a popular remedy for performance anxiety, also known as stage fright. They may also have some use in PTSD. The alpha-blocker prazosin (Minipress) eases nightmares from PTSD. Other alpha-blockers, such as clonidine (Catapres) and guanfacine (Tenex), may also be useful for treating PTSD.

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