The most effective prescription drugs for the treatment of generalized anxiety disorder are benzodiazepines, SSRIs (Zoloft, Prozac, Paxil, etc.), SNRIs (Effexor, Cymbalta, etc.), and buspirone (BuSpar). Other drugs that may be useful are tricyclic drugs (Nortriptyline, Amitriptyline, etc.) and beta-adrenergic antagonists or blockers (Propranolol).
To treat panic disorders, selective serotonin reuptake inhibitors (SSRIs) and clomipramine (Anafranil) are shown to be more effective and better tolerated than benzodiazepines, and monoamine oxidase inhibitors, and tricyclic and tetracyclic drugs. Some reports suggest a role for venlafaxine (Effexor) and buspirone (BuSpar). Venlafaxine is approved for the treatment of generalized anxiety disorder and may help in patients with both panic disorder and depression.
Agoraphobia is a marked fear or anxiety about two or more of the following situations:
The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (e.g., fear of incontinence or fear of falling in the elderly). The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety. The fear, anxiety, or avoidance typically lasts for 6 months or more and causes significant distress or impairment in social, occupational, or other important areas of functioning.
Agoraphobia will be diagnosed irrespective of the presence of panic disorder.
The lifetime prevalence of agoraphobia varies between 2 to 6 percent across studies.
Agoraphobia vs. Other Disorders
Agoraphobia must be differentiated from a number of other medical conditions that produce similar symptoms. These include major depressive disorder, schizophrenia, paranoid personality disorder, avoidance personality disorder, and dependent personality disorder.
Benzodiazepines have the most rapid onset of action against panic. Xanax and Ativan are the most commonly prescribed benzodiazepines. Clonazepam has also been shown to be effective.
Benzodiazepines have the potential for dependency, cognitive impairment, and abuse, especially with long-term use. However, when used appropriately under medical supervision benzodiazepines are effective and generally well-tolerated. Their most common side effects are mild dizziness and sedation, both of which are often reduced by time or by adjustment of dosing.
Selective serotonin reuptake inhibitors (SSRIs) are considered the first-line agents for the treatment of panic disorders with or without agoraphobia, and they can help reduce or prevent relapse. The main advantage of SSRIs is their improved safety profile and more tolerable side effects.
Tricyclic and tetracyclic drugs are also effective treatments, although they require careful dosing and close monitoring of side effects, which can include jitteriness, possible seizures, and potentially harmful cardiac effects.
A variety of different types of psychotherapy may be used to treat agoraphobia.
Mental Health Library Sources:
Information included in all topics of the Mental Health Library comes from the Desk Reference to the Diagnostic Criteria From DSM-5 and Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. Complete diagnostic and treatment information may be found within these publications.
Information within the Mental Health Library is not intended to be used for self-diagnosis purposes. Rather, it is provided as a public educational service to make people aware of mental health conditions. Please consult a qualified mental health professional for a diagnosis of any suspected mental health illness.
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