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Deborah Wiig
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Pharmacist with medicationsGuide to psychotropic drugs
Common medications for
anxiety -- bipolar disorder -- depression

This information applies to adults only


 

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Anxiety Disorders
Different types of medications are used to treat different anxiety disorders, such as generalized anxiety disorder, panic disorder, social phobias and others.

While medications can be very effective in treating many of the symptoms of anxiety disorders, such as worry, panic attacks, insomnia, and difficulty concentrating, according to the Anxiety Disorders Association of America, they have limitations. To achieve complete remission of symptoms, you may need to make some important changes in your life. You might also benefit from psychotherapy.

Side effects with antianxiety medications depend on the drug and the dosage. They occur only in some people and are often temporary, and include dizziness, drowsiness, fatigue, tremors, dry mouth, headaches, nausea, upset stomach, and reduced sexual drive or performance. Tell your doctor if side effects persist.

 

GAD = Generalized Anxiety Disorder,

OCD = Obsessive Compulsive Disorder,

PD = Panic Disorder,

PTSD = Post Traumatic Stress Disorder,

SAD = Social Anxiety Disorder

Antidepressants, especially SSRIs, are prescribed to treat many anxiety disorders. See Antidepressants below. PD, OCD, SAD, GAD, PTSD

Anxiolytics
Azapirones: BuSpar (G) * (Buspirone)

  (G) Generic version available
* Although this medication has not been approved by the FDA for this use, it has been found to be useful in the treatment of this disorder. This practice is known as "off-label" use, which is common and considered acceptable by the FDA.

Benzodiazepines GAD, SAD, PD High-potency benzodiazepines combat anxiety and have few side effects other than drowsiness. Because people can get used to them and may need higher and higher doses to get the same effect, benzodiazepines are generally prescribed for short periods of time. Some people experience withdrawal symptoms if they stop taking benzodiazepines abruptly instead of tapering off, and anxiety can return once the medication is stopped.

  Ativan (G) (Lorazepam)
Dalmane (G) (Flurazepam)
Klonopin (G) * (Clonazepam)
Halcion (G) (Triazolam)
Librium (G) (Chlordiazepoxide)
Restoril (G) (Temazepam)
Serax (G) (Oxazepam)
Tranxene (G) (Clorazepate)
Valium (G) (Diazepam)
Xanax (Alprazolam)
Antihistamines GAD
Atarax, Vistaril (G) (Hydroxyzine)

Anticonvulsants These medications may be combined with other medications when necessary.

 

Gabitril (Tiagabine)
Neurontin (Gabapentin)
Depakote (G) (Valproate)
Lamictal (Lamotrigine)
Topimax (Topiramate)

Noradrenergic Agents
Beta Blockers Performance anxiety, possibly PD
Inderal (G) (Propranolol)
Tenormin (G) (Atenolol)
....................(Prazosin)

Atypical Antipsychotics These medications may be used with other medications when necessary.

 

Alpha Blocker PTSD (nightmares) Minipress (G) (Prazosin)
Catapres (Clonidine)
Tenex (Guanfacine)



Abilify Aripiprazole Geodon Ziprasidone Risperdal Risperidone Seroquel Quetiepine Zyprexa Olanzapine



Bipolar Disorder
Depending on the medication, side effects, which occur only in some people and are often temporary, may include weight gain, dry mouth, insomnia, nausea, tremor, reduced sexual drive or performance, anxiety, or movement problems. Tell your doctor if side effects persist.

  (G) Generic version available
* Although this medication has not been approved by the FDA for this use, it has been found to be useful in the treatment of this disorder. This practice is known as "off-label" use, which is common and considered acceptable by the FDA.


Mood Stabilizers
Medications known as "mood stabilizers" are commonly prescribed to help control the symptoms of bipolar disorder. Anticonvulsant medications may be combined with lithium, or with each other, for maximum effect. Other medications are added when necessary, typically for shorter periods, to treat episodes of mania or depression.

 
Depakene (G) (valproic acid)
Depakote (G)
Eskalith, Lithane, Lithobid, Lithium (lithium carbonate) (G)
Lamictal * (lamotrigine)
Lithobid (G) (lithium)
Lithonate
Lithotabs
Neurontin * (gabapentin)
Tegretol (G) (carbamazepine)
Topamax * (topiramate)
Antidepressants for bipolar disorder
People with bipolar disorder who take antidepressants are at risk of switching into mania or hypomania, therefore antidepressants are usually prescribed only in combination with mood stabilizing medications. Lithium and valproate are the most commonly used mood-stabilizing drugs today. However, research studies continue to evaluate the potential mood-stabilizing effects of newer medications.
 

Seroquel (quetiapine) (The only antidepressant approved for bipolar depression)

Symbyax (a combination of olanzapine, an atypical antipsychotic and fluoxetine, a selective serotonin reuptake inhibitor) for the treatment of depressive episodes associated with Bipolar I Disorder.

 

Antipsychotics for mania
Abilify (Aripiprazole)
Haldol (G) (haloperidol)
Loxitane (loxapine)
Mellaril (G) (thioridazine)
Moban (molindone)
Navane (G) (thiothixene)
Prolixin(G) (fluphenazine)
Serentil (mesoridazine)
Seroquel (quetiapine)
Stelazine (G) (trifluoperazine)
Thorazine (G) (chlorpromazine)
Trilafon (G) (perphenazine)
 

Atypical Antipsychotics for mania
Abilify (aripiprazole)
Clozaril (G) (clozapine)
Risperdal (risperidone)
Seroquel (quetiapine)
Zyprexa (olanzapine)




Depression
Antidepressants These can lift the dark, heavy moods of depression. Many people with depression do best with combined treatment: medication to gain symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depression.

Antidepressants may take several weeks to become fully effective and it may take more than one trial to find the most effective one for you. Side effects of antidepressants, which occur only in some people and are often temporary, may include: reduced sexual drive or performance, headache, nervousness, sleeping problems, drowsiness. If side effects persist, talk to your doctor.

Tricyclics
Anafranil * (G) (clomipramine)
Asendin (amoxapine)
Elavil(G) (amitriptyline)
Norpramin (G) (desipramine)
Pamelor (nortriptyline)
Sinequan (G) (doxepin)
Surmontil (trimipramine)
Tofranil (imipramine)
Vivactil(G) (protiptyline)

MAOIs- monoamine oxidase inhibitors
Nardil (phenelzine)
Parnate (tranylcypromine)

 

 

(G) Generic version available
* Although this medication has not been approved by the FDA for this use, it has been found to be useful in the treatment of this disorder. This practice is known as "off-label" use, which is common and considered acceptable by the FDA.

SNRIs -- Dual-uptake inhibitors
Cymbalta (duloxetine)
Effexor (venlafaxine)
Remeron (mirtazapine)

SSRIs--selective serotonin re-uptake inhibitors:
Celexa (G) (citalopram)
Lexapro (escitalopram)
Paxil (paroxetine)
Prozac (G) (fluoxetine)
Zoloft (sertraline)
Symbyax (a combination of olanzapine, an atypical antipsychotic and fluoxetine, a selective serotonin reuptake inhibitor) for the treatment of Treatment Resistant Depression.

Similar to SSRIs
Desyrel (G) (trazadone)
Serzone (nefazodone)

In a class by itself
Wellbutrin (G) (bupropion)

 

Sources
Anxiety Disorders Assn of America
NAMI
NIMH
Jim Phelps, M.D.
 

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Page updated January 1, 2011