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Int Clin Psychopharmacol ;10 Suppl Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine. Zullino DF, Riquier F. What should I take for panic attacks? In the United States, starting on anxiety medication requires communicating with a healthcare professional to have a prescription issued for you. If you do not already have a family doctor, we can help you find a healthcare provider.
Family doctors or primary care providers tend to have their own shortlist of anxiety medications that they consistently prescribe from, based on their professional experience. Most people would prefer to play an active role in their healthcare. With evidence-based guidelines and a few considerations, you can go into the discussion as an informed consumer. You can familiarize yourself with the best available options and prepare your own suggestions.
Selective serotonin reuptake inhibitors SSRIs are medications that increase brain serotonin levels by preventing the reabsorption of serotonin. Low serotonin levels are linked to anxiety and depression. Serotonin-norepinephrine reuptake inhibitors SNRIs are medications that work by blocking the reabsorption of both serotonin and norepinephrine in the brain. Norepinephrine has many essential functions and helps the body respond to stressful situations. Before they can be marketed, prescription medicines must go through an extensive approval process to prove that they work and that their benefits outweigh their risks.
It takes an average of 12 years for a new drug to hit the pharmacy shelves, and hundreds of millions of dollars are spent on research, development, and clinical trials. Note that the FDA does not actually perform testing; it only reviews the testing process. Off-label prescribing is very common for the treatment of various types of anxiety disorders but typically not before trying first-line options. Escitalopram Lexapro is generally well tolerated and has fewer reported side effects compared to paroxetine Paxil , duloxetine Cymbalta , and venlafaxine Effexor XR.
Paroxetine Paxil may cause more weight gain and should be avoided in people who struggle to maintain a healthy weight. Paroxetine is not a good choice for older adults, for people with a history of heart problems, or people taking multiple medicines due to its risk of drug interactions. Medical researchers have performed head-to-head comparison studies of escitalopram Lexapro and venlafaxine Effexor XR for the treatment of GAD. The study results concluded that overall, escitalopram and venlafaxine are equally effective treatments for GAD.
However, more of the study participants reported that they quit taking venlafaxine due to side effects compared to escitalopram, which was better tolerated with fewer side effects. Paroxetine Paxil was the first medication to receive FDA approval for the indication of social anxiety disorder and is frequently still chosen as first-line treatment by healthcare providers for that reason.
As mentioned under GAD, the side effects and safety concerns of paroxetine limit its use. Sertraline Zoloft has a more favorable safety profile compared to paroxetine. Sertraline is the safest SSRI for people with a history of heart problems. Sertraline is also considered safe in pregnancy, breastfeeding, and is approved for use in teens as well as adults. Fluvoxamine Luvox has more potential to interact with other medications, and its effects can be decreased by smoking cigarettes.
However, these interactions can be managed with dose adjustments, and fluvoxamine may be the right choice, especially for people who have both social anxiety and obsessive-compulsive disorder OCD.
The FDA has approved five medications for the treatment of obsessive-compulsive disorder OCD , which include the following four SSRIs, which are considered first-line treatment options:. Clomipramine is still an available treatment for OCD in adults and children 10 years and older , but due to its unfavorable side effects, SSRIs are now preferred as first-line.
Sertraline and fluoxetine are both well-tolerated compared to paroxetine Paxil. Paroxetine Paxil is the SSRI most likely to cause weight gain and should be avoided as the first-line option.
It may take a trial of 10 to 12 weeks to see improvement. The downside of switching is that this may take another 10 to 12 weeks of waiting to see improvement of the OCD symptoms.
Effexor and Lexapro are used to treat mental health disorders such as major depression and generalized anxiety. The effects of Effexor and Lexapro are not immediate.
It may take between two and six weeks to see any effect from the drugs. It is important to understand that the remission of symptoms may not be immediate, and patients should be encouraged not to discontinue treatment without first consulting their prescriber. Patients with depression may experience a worsening of symptoms or suicidal thoughts whether or not they are taking antidepressant medications. These conditions may worsen until remission is achieved.
Effexor and Lexapro therapy may increase suicidal ideation and thoughts among teens and young adults, especially in the early stages of treatment before any type of remission is achieved. These patients must be monitored closely, and a change may be necessary if symptoms suddenly arise or get worse. Serotonin syndrome has been associated with the use of Effexor, Lexapro, and other similar antidepressant medications.
It is associated with too much free serotonin and can cause increased heart rate, agitation, and dizziness. The risk of serotonin syndrome is increased when other serotonergic drugs are used with Effexor or Lexapro.
Stopping these medications suddenly may lead to withdrawal symptoms such as headaches, dizziness, fatigue, and irritability. Effexor is a prescription antidepressant medication used in the treatment of major depression and generalized anxiety disorder.
It works by increasing free serotonin and norepinephrine. Lexapro is available in immediate and extended-release tablets, and extended-release capsules. Lexapro is a prescription antidepressant medication used in the treatment of major depression and generalized anxiety disorder. It works by increasing free serotonin. Lexapro is available as an oral tablet and an oral solution. While both Effexor and Lexapro treat depression and anxiety, they are not the same.
Effexor blocks the reuptake of both serotonin and norepinephrine in the neuronal synapse, while Lexapro blocks only serotonin reuptake. Effexor and Lexapro have been shown to be comparable in terms of efficacy in treating depression, however, studies suggest that Lexapro may be easier to tolerate. Patients on Lexapro are less likely to discontinue treatment early.
The Food and Drug Administration FDA considers both Effexor and Lexapro to be in pregnancy category C, meaning there have not been adequate human studies to determine safety. The use of these drugs should be limited to use when the benefits clearly outweigh the risks.
Both Effexor and Lexapro should be avoided in breastfeeding mothers as well. Alcohol can increase the adverse effects of both Effexor and Lexapro. Drinking alcohol while taking these drugs can cause significant psychomotor impairment, and for this reason, patients are advised to avoid alcohol if taking these drugs. Effexor has been shown to be just as effective, if not more, than most other antidepressant drugs.
However, it may be more difficult to tolerate for patients. Your doctor will decide which treatment option is best for you. Venlafaxine is the generic name of Effexor, which is a brand name product. Generic venlafaxine products are considered substitutable for Effexor by the FDA. While some patients may experience somnolence while on Effexor, it is also known to cause agitation and tremor in some patients. Talk with your physician to determine if this drug may be right for you.
Amnesia has been reported in a small number of patients taking Effexor products. If you notice this adverse event, let your prescriber know immediately as a change in therapy may be warranted.
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