Medications for Stress

Stress is an unavoidable condition of life. Whether it's in the form of demands at work, being stuck in traffic, fighting with a spouse or raising a special-needs child, stress pervades our lives, and we learn to cope. But acute stress, stress that persists for a long time, may require medical intervention.

Definition

• When a stress-inducing event occurs, the body gears up to give us the energy we need to deal with it. This "fight or flight" response results in the release of hormones that increase the rate of the heart and the supply of blood, make more glucose available for quick energy and make our breathing more rapid. As the stress goes down, the hormone levels drop, and our body systems return to normal. But if stress remains high for a long time, then the hormone levels also remain high, and over time this constant level of "readiness" causes physical and emotional harm.

Treatment

• For normal everyday stress, relaxation, meditation, coping strategies, diet, exercise and a healthy lifestyle are the best treatment. Medications are not the first line of treatment, but if they become necessary, they are prescribed to target the individual symptoms, such as depression and anxiety.

Anti-Anxiety Medications

• Anti-anxiety medications relieve symptoms related to stress by slowing down the central nervous system. This class includes the benzodiazepines: Xanax, Valium, Ativan, Librium and Klonopin. These medications are always started at a low dose and increased only as necessary. They may cause withdrawal symptoms, so they should never be stopped suddenly. Other common side effects include drowsiness, dizziness, clumsiness, confusion, depression, nausea, forgetfulness and blurred vision.

  Buspar is an anti-anxiety medication that has a different way of working than the benzodiazepines, so it does not have the same sedative effects. It also helps with physical symptoms such as dizziness and a pounding heartbeat.

Anti-Depressants

• There are several classes of antidepressants: selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and serotonin norepinephrine reuptake inhibitors (SNRIs). The SSRIs (Prozac, Luvox, Zoloft, Paxil, Lexapro, Celexa) and SNRIs (Pristiq, Savella, Effexor, Cymbalta) are preferred because they have fewer side effects. They both work by making more neurotransmitters (serotonin and/or norepinephrine) available for the brain to use, and this helps depression.

Beta Blockers

• Beta blockers are used to treat high blood pressure, but they're also used "off-label" for anxiety, which means they're being used for a purpose (anxiety) that has not yet been approved, but that has been found effective. They block the hormone that triggers that "fight or flight" response, helping to control physical symptoms of stress. The beta blockers---Inderal and Tenormin---commonly cause sleepiness, nausea and light-headedness.

Hydroxyzine

• Hydroxyzine is an antihistamine that has been approved for the treatment of anxiety and tension. It is also a sedative that is used as a premedication before anesthesia for surgery is administered.

Barbituates

• These medications cause sedation and reduce anxiety, but they also have a high risk for addiction and are rarely used.