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Should Anxiety Be Treated with Benzodiazepines? (Alternatives)

Benzodiazepines (benzos) are a class of prescription medications that are primarily used to treat anxiety, but they can also be prescribed to treat panic disorders, seizures, and insomnia, as well as alcohol withdrawal symptoms.

Benzos are also sometimes administered to sedate people before they have operations or diagnostic procedures done because of the anxiety they feel before going into surgery.

Scientists are not sure exactly how benzos work on your brain, though they do know that they interact with neurotransmitters such as gamma-Aminobutyric acid (GABA).

GABA is responsible for inhibiting neural activity in your brain. People who struggle with anxiety or seizure disorders may have excessive neural activity. By increasing the effects of GABA in the brain, benzodiazepines help to calm the nervous system.

BENZODIAZEPINES FOR ANXIETY

Benzos are one of the most commonly prescribed medications in the United States, and anxiety is the most frequent condition they are prescribed to treat. Anxiety is the most common mental health issue in the country, affecting more than 18 percent of adults every year. Despite the high rates of positive treatment outcomes for anxiety, fewer than 37 percent of people struggling with anxiety receive treatment.

For people who do seek treatment for anxiety disorders, benzos are frequently prescribed. Their calming effects can be felt relatively quickly, whether they are taken daily or only as-needed.

Common benzos prescribed for the treatment of anxiety and panic disorders include:

  •  Xanax (alprazolam)
  •  Valium (clonazepam)
  •  Ativan (lorazepam)
  •  Klonopin (clonazepam)
  •  Librium (chlordiazepoxide)

Prescriptions for benzodiazepines must be highly individualized, as they are known to be habit-forming. Therefore, it is recommended to begin patients on minimal doses until an effective therapeutic dose is reached. It is not recommended to take benzos for more than a few months, however, as dependence is likely to occur. Once you have developed a dependence on benzos, you will need to gradually taper off them to avoid experiencing unpleasant and dangerous withdrawal symptoms.

RISKS OF USING BENZOS TO TREAT ANXIETY

The greatest risk of using benzos to treat anxiety is the chance of developing dependence on and addiction to the medication. Tolerance is likely to form within your first few days or weeks of benzo use. Dependence, however, indicates a physical and/or emotional reliance on the drug that usually occurs after a few months of daily use.

Once you have developed dependence, it is important to be very cautious about how you reduce your benzo intake. Your doctor can help you make a tapering plan to gradually wean you off the drug. It is important to taper off the prescription to ensure a safe withdrawal process and to ensure that your drug use does not progress to addiction.

Risks associated with long-term benzo use include:

  •  Dependence and addiction
  •  Experience of adverse side effects
  •  Overdose
  •  Dangerous interactions with other medications and alcohol
  •  Prescription drug misuse
  •  Return and worsening of anxiety symptoms when you stop taking benzos

Misuse of benzodiazepines begins when people take more than their doctor recommended, take them for longer than they intended to, or are only using them for recreational reasons. The misuse of prescription medications has led to a national health crisis in the United States. Opioid painkillers and anti-anxiety medications, such as benzodiazepines, are the most commonly abused drugs.

The potential for misuse of benzos is of great concern. Between 2010 and 2014, more than 6,500 people died from an overdose that involved benzodiazepines, and 124,000-plus people were admitted to emergency rooms in 2010 as a result of benzodiazepine-related complications. Part of this misuse is due to a history of doctors overprescribing medications as quick fixes for conditions like anxiety. In 2011, 127 million prescriptions were filled for benzos.

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DOCTOR-RECOMMENDED WAYS TO TREAT ANXIETY

The potential for benzodiazepine abuse is high. In response to the prescription overdose epidemic that has spread across the nation, doctors are writing fewer prescriptions and recommending alternatives. In some situations, medications still play an essential role in helping people monitor severe anxiety. In many other situations, however, different forms of treatment may be more appropriate.

The two main types of treatment for anxiety disorders are therapy and medication, or a combination of the two. Doctors will establish treatment plans based on how significantly your symptoms of anxiety are affecting your daily life. They may conduct a physical exam and psychological screenings to get a better understanding of your symptoms. From there, they can make an informed recommendation as well as referrals for proper treatment.

Benzodiazepines, as well as antidepressants, can be prescribed to treat acute anxiety symptoms. Antidepressants are generally not habit-forming medications, so your doctor may allow you to take them for longer than it would be safe to take benzos. Both types of medication, however, can only manage symptoms. They do not treat the underlying causes of your anxiety.

To address the underlying cause of anxiety and get to the root of the problem so that it does not present itself again, most doctors recommend participating in therapy.

Cognitive behavioral therapy (CBT) is an effective form of therapy to help people learn to manage their anxiety on their own. CBT focuses on teaching you skills to help you gain control over your anxieties.

The more skills you develop, the more control you gain over your emotions, and the less likely you are to be overcome by anxiety.

Stressed woman covering her face and sitting on the floor

Often, doctors may recommend a combination of medication and therapy. Medication may be necessary in the beginning to reduce symptoms enough so that participation in therapy is possible.

As the individual becomes comfortable in therapy and learns new coping skills, however, medication can be reduced. Eventually, the individual is no longer reliant on medication to manage their anxiety; instead, they use the self-help skills they learned in therapy.

ALTERNATIVE ANXIETY TREATMENTS

In addition to medications and therapy, there are many well-studied and effective alternative treatments for anxiety available. Even if you are taking anti-anxiety medication, enhancing your treatment with natural remedies and lifestyle changes can be beneficial. Always consult your doctor before taking any herbal supplements, however, as some herbs can interact with prescription medications.

Natural alternatives that can help manage anxiety include:

Exercise is known to reduce anxious energy and support physical and mental health.

Mediation promotes mindfulness and can help to slow racing thoughts.

Relaxation exercises learned through yoga can teach you how to relax unconsciously tightened muscles, thereby reducing stress.

Keeping a journal or doing creative writing can help people to express their feelings and cope with their anxiety better.

The calming scent of plant oils, particularly lavender, helps some people to feel less stress and anxiety.

Derived from the marijuana plant, but without the active ingredient that produces a high, early research shows that CBD oil may significantly reduce symptoms of anxiety and panic.

For centuries, herbal supplements, like chamomile, valerian, passion flower, and St. John’s wort, have been used in ancient Chinese medicinal practices to relieve anxieties.

The above is not an exclusive list of alternative treatments for anxiety. If you are struggling with symptoms of anxiety and would like treatment comes without the risks associated with benzodiazepine use, there are many options available. Benzos play a key medical role for many people, but you just might be able to gain control over your anxiety through a combination of safer alternatives.

Sources

Benzodiazepines. RxList from https://www.rxlist.com/benzodiazepines/drugs-condition.htm

(July 2018). Benzodiazepines for the Treatment of Anxiety. Verywell Mind from https://www.verywellmind.com/benzodiazepines-for-the-treatment-of-anxiety-2584334

Prescription Drug Overdose. American Public Health Association from https://www.apha.org/topics-and-issues/prescription-drug-overdose

Facts and Statistics. Anxiety and Depression Association of America from https://adaa.org/about-adaa/press-room/facts-statistics

(October 2017). Generalized Anxiety Disorder. Mayo Clinic from https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/diagnosis-treatment/drc-20361045

(July 2018). How to Treat Anxiety Naturally. Medical News Today from https://www.medicalnewstoday.com/articles/322396.php

(May 2014). The Hidden Dangers of Benzodiazepines. Psychology Today. from https://www.psychologytoday.com/us/blog/side-effects/201405/the-hidden-dangers-benzodiazepines

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