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What Is The Safest Drug for Anxiety?

When it comes to treating your anxiety, medications are the clear favorite. Most people know that medicines can have side effects that make them somewhat dangerous for regular use, but medicine itself represents something that many people prefer: an immediate, rapid way to fight anxiety.

The problem is that anti-anxiety medications are notorious for their side effects. Unlike prescription medications for other health issues, anxiety medicines deal directly with the brain, and any time you're taking something that affects your brain there are serious risks. Below, we'll review the risks of choosing anti-depressants and other anxiety medicines, and then explain which medications are likely the "safest" depending on your perspective.

Medications Can't Cure Anxiety – This Does

Prescription medications are not an anxiety cure. They're a way for you to dull the symptoms so that you can temporarily manage your anxiety. What if you could cure it forever?

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Safest Medications For Anxiety

The first thing to realize is that different anxiety disorders require different types of medications. So even if there is a "safest" anxiety medicine, the problem is that your own anxiety may not be helped by that medicine. Furthermore, different levels of anxiety may require different types of medications as well.

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It's important to remember that all medicines have side effects, especially medications that affect brain chemistry. In addition, everyone has different needs, different brains, and even different chemical imbalances that may lead to anxiety. That's why you should never take any medicine without your doctor's approval and supervision.

What is a "Safe" Anxiety Medicine?

It's also difficult to discuss the safety of antidepressants for anxiety and other anxiety medicines because the word "Safe" means different things to different people. The good thing about most anxiety medications is that none of them appear to have fatal side effects. All medications can have some exceedingly rare side effects that may not be known, and allergies to medicine can be very dangerous, but antidepressants, benzodiazepines, and others are highly unlikely to cause any severe or possibly fatal side effects. You can talk to your pharmacist if you're worried.

But anxiety medicines can cause two distinct types of side effects:

  • Physical
  • Psychological

Physical side effects are those that cause some type of physical discomfort. For example, SSRIs (a type of antidepressant) may cause:

  • Nausea
  • Sweating
  • Diarrhea/Constipation
  • Headaches
  • Dry Mouth
  • Weight Gain
  • Cloudy Thinking
  • Digestion Issues

These side effects may be disruptive enough to affect your wellbeing. Benzodiazepines may also cause digestion issues and nausea, and have other side effects that include:

  • Hypotension (low blood pressure)
  • Blurred Vision
  • Severe Fatigue/Impaired Driving Skills
  • Lack of Coordination
  • Seizures

In some cases, the side effects can be severe enough that the person needs to stop taking the medication right away. They also may cause dependency and withdrawal symptoms if you stop taking the medications, and in some cases they may lose their effects over time as a result of tolerance.

Even though physical side effects appear to be common with all medicines for anxiety, the reality is that it's the psychological side effects that cause the biggest issues. Unfortunately, it's impossible to know how the drugs will affect you unless you take them. Common side effects of these types of psychoactive medications include:

  • Paradoxical Effects – In some cases, anti-depressants and anti-anxiety medications can actually increase the symptoms of your anxiety disorder. It's unclear why, or who this effects, but many people find that their anxiety and depression actually increases while taking the drugs.
  • Personality Changes – Many of these drugs can also lead to personality changes. In some cases they may be emotional, like increased agitation. In others, it may simply be a change in how you act around others and what you enjoy.
  • Sexual Side Effects – Many benzodiazepines and antidepressants cause a loss of libido. That loss of sex drive may lead to decreased energy for intercourse, the inability to get aroused, or problems with performance or perceived performance.
  • Cognitive Issues – Because these drugs affect your brain chemistry, they may alter the way your mind works. You may have trouble remembering things, trouble concentrating, or trouble thinking quickly. In some cases, these are actually the purpose of the drug. Benzodiazepines are designed to cause physical and mental fatigue so that you cannot feel as anxious. In others, they may be an unwanted side effect.
  • "Brain Zaps" and Other Issues – Finally, some anxiety medications may cause you to feel symptoms that can best be described as unusual. For example, some cause what's known as "brain zaps" which make you feel like your mind is getting a jolt of electricity. Others may lead to your eyes feeling "nervy" or your movements feeling unusual. These symptoms are usually temporary and rarely dangerous, but they can make it harder to take these medications.

For some, physical side effects and fatality risk are the true sign of a drug's "safety." For others, it may be the way it affects you psychologically.

As we mentioned, because each person reacts differently to different medications and has different views on what is considered a safe medicine, there is no truly safe option.

However, since that answer is unlikely to please anyone, the safest anti-anxiety option is likely something weaker, like Buspirone (also known as Buspar). This type of medicine does cause brain zaps and some of the unusual "nervy" sensations, but isn't likely to cause more severe anxiety or as much fatigue. Buspirone isn't a controlled substance either, because it's not a drug of abuse like anti-depressants and benzodiazepines.

The problem with Buspar is that it tends to be too weak for many of those with anxiety, and isn't considered helpful for panic disorder or depression. It's generally considered a mild generalized anxiety drug, and may not be the right option for you.

Cure Anxiety – Don't Just Numb It

All medicines are also just temporary fixes, and in some cases they can make your long term outlook worse. You cannot and should not take anxiety medications forever, but the more you use them, the more you depend on them, and the more you depend on them the harder it will be to reduce your anxiety when you finally stop taking the medications.

Doctors and psychologists all agree that medications alone simply aren't enough, and while they may be useful for temporary relief, they're not something that should be depended on for the rest of your life. For that, you need to make sure you commit to long term, effective strategies for controlling anxiety.

I have developed a test that will help. This free test will take only 7 minutes of your time and it will look at your symptoms to help you understand your specific anxiety better and what you can do to treat it.

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Goldberg, Harold L., and Richard J. Finnerty. The comparative efficacy of buspirone and diazepam in the treatment of anxiety. The American journal of psychiatry (1979).

Julien, Robert M. A Primer of Drug Action: A Concise Nontechnical Guide to the Actions, Uses, and Side Effects of Psychoactive Drugs, Revised and Updated. Holt Paperbacks, 2001.

American Family Physician. Addiction: Part I. Benzodiazepines—side effects, abuse risk and alternatives. Am Fam Physician 61.7 (2000): 2121-2128.

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