Anxiety disorder - treatment

Prescription medication
The acute symptoms of anxiety are most often controlled with anxiolytic agents such as benzodiazepines. Diazepam (Valium) was one of the first such drugs. Today there are a wide range of anti-anxiety agents that are based on benzodiazepines, although only two have been approved for panic attacks, clonazepam (Klonopin) and alprazolam (Xanax). All benzodiazepines may induce dependency, and extended use should be carefully monitored by a physician, preferably a psychiatrist. It is very important that once placed on a regimen of regular benzodiazepine use, the user should not abruptly discontinue the medication.

Some of the selective serotonin reuptake inhibitors (SSRIs) have been used with varying degrees of success to treat patients with chronic anxiety, the best results seen with those who exhibit symptoms of clinical depression and non-specific anxiety or general anxiety disorder concurrently. Beta blockers are also sometimes used to treat the somatic symptoms associated with anxiety, especially the shakiness of "stage fright." According to publications written on stage fright and nervousness with musicians, Beta Blocker therapy has proven helpful.

The addictive nature of the benzodiazepine class became apparent in the mid 1960s when Valium (Diazepam), the first drug in the class to win FDA approval, resulted in thousands of people who quickly showed the classic symptoms of addiction when used for more than a week or two consistently. However, other scientific research indicates that "the vast majority of the use of benzodiazepines is appropriate".

Cognitive-behavioral therapy
Cognitive-behavioral therapy (CBT) is a form of psychotherapy often recommended for the treatment of anxiety disorders. The goal of the cognitive-behavioral therapist is to decrease avoidance behaviors and help the patient develop coping skills. Each individual's therapy is unique; however, there are common components in Cognitive Behavior Therapy treatment of an Anxiety Disorder. Education about a particular Anxiety Disorder and how it is interfering in key areas of life must be addressed first. Treatment may begin by addressing "readiness" issues or "treatment interfering behaviors". This may entail:


 * Challenging false or self-defeating beliefs
 * Developing a positive self-talk skill
 * Developing negative thought replacement
 * Systematic desensitization, also called exposure (used for agoraphobia, phobias, panic disorder, and OCD mainly)
 * Providing knowledge that will help the patient cope (For example, someone who suffers from panic may be informed that fast, prolonged, heart palpitations are in themselves harmless.)

Supplements
A variety of over the counter supplements and medications are also used for their alleged anti-anxiety properties; however, there is little scientific evidence to back up these claims.


 * Kava - a popular herbal treatment; small doses either taken regularly through the day or when early symptoms are noticed by the patient.
 * Valerian root - also reputed to have anti-anxiety and sedative properties.
 * passion fruit
 * passion flower - has a mild tranquilizing effect without being sedating, a useful adjunct to programs of stress reduction.
 * St. John's wort - The flowers and leaves of the St John's Wort plant (Hypericum perforatum) are used to make the herbal remedies. These flowers and leaves contain many different compounds including hypericin, which is thought to be one of the compounds that makes some people believe that St John's Wort is helpful for depression and anxiety.
 * Hops - alleged to have a relaxing and sedative effect on the central nervous system, may also ease cravings for alcohol
 * Chamomile
 * B-complex
 * L-Tryptophan and 5-HTP - Precursors used by the body for the synthesis of serotonin
 * GABA

Alternative medicine
A 2002 CDC survey (see table 3 on page 9) found that complementary and alternative methods were used to treat anxiety/depression by 4.5 percent of U.S. adults who used CAM.