What side effects can I expect from anxiety medications?

Hi. It’s Jenny at AnxietyBoss.com. Our question today comes to us from Dorian in Philadelphia. What side effects can I expect from anxiety medications?

It depends on the medications you’re prescribed. There are generally three types of medication prescribed for anxiety. SSRIs, or selective serotonin reuptake inhibitors; second, benzodiazepines; third and less frequently, beta-blockers. Now all of these have different side effects.

SSRIs increase the available levels of serotonin, which is a neurotransmitter or brain chemical. It’s associated with the regulation of mood and anxiety. SSRIs tend to produce some stomach upset when they are first started for the first week or two. You may get some queasiness, cramps, and diarrhea. You may feel tired and need to take naps or get some extra sleep when you first take them. Once your body gets used to them, you should be completely awake and alert on them. Both men and women do tend to experience orgasmic delay or inability to reach orgasm. These side effects also tend to go away after a couple of weeks as your body adapts to the medication.

Another side effect that many people find enjoyable is vivid dreaming. Your dreams may be very long, detailed, vivid, and clearly recalled. SSRIs have received some bad press. There are dramatic fear-provoking stories about the use of SSRIs and violent or suicidal behavior in the media, which are not based on scientific fact. TV commercials for SSRIs, commercials for attorneys offering to sue physicians or pharmaceutical companies for harm resulting from the use of SSRIs, as well as patient information included in the packaging of the medication will have a warning that use of SSRIs has been associated with increased suicidal thinking, especially in adolescents.

Now this is more complex than what a 30-second commercial, a warning label, or a reporter who knows nothing about psychopharmacology or an attorney eager to make money on a contingency-based lawsuit, can or will explain. The incidents of increased suicidal thinking according to a breakdown of studies is about 0.04 percent. That’s about four people out of a thousand who take SSRIs will experience an increase in suicidal thinking.

All medications have to be prescribed on the basis of risk of harm versus safety and effectiveness. An important question to answer is how many people who are anxious and depressed who are not taking SSRIs experience suicidal thinking? Another consideration is that people that are very anxious and depressed, the two often go together, will not have the energy or focus to plan and carry out suicide. However, once they start taking medications, two things happen. These meds work very slowly. You may not feel any result for up to a month. Your depression and anxiety will slowly lift. Your mood and your ability to gather your thoughts will improve. People can enter a window here of risk. At this point because they are now, number one, focused and energized enough to make a plan to commit suicide and carry it out; and number two, they will have a clear memory of several weeks ago when they were in despair and they will never want to go there again.

Monitoring by family and friends, regular contact, and communication with a therapist and the prescribing physician is critical for people that are severely depressed and have expressed any past suicidal thinking or made any attempts.

Benzodiazepines are tranquilizers and they must be used with caution. They are very addictive and can cause dizziness, memory problems, sleepiness, and difficulty concentrating. You must take care using them while driving or doing other tasks which require your full attention and could be potentially hazardous. It is very important not to mix them with alcohol. The sedation and amnesia effects of the benzodiazepines will be greatly magnified and you can put yourself into a black out or a period of time where you will not have any memory, or a coma, where you will be unconscious for an extended period of time, maybe even for good.

Now these meds also should not be used by anyone with a history of addiction to drugs or alcohol unless there are very critical quality of life or safety issues. They must be used with a great deal of caution and monitoring. For example, medication counts to make certain the patient is not taking more medications than prescribed. Urine toxicology screens to make sure the meds are being taken instead of sold, and they should be used for a short of a period of time as possible.

Beta-blockers also prevent too much adrenaline from going into your heart and, thereby, prevent increased heart rate, blood pressure, trembling, and sweating. They can cause men to develop erectile problems, but usually only in high doses. Your hands and feet may be more sensitive to the cold as well, but again, this typically only occurs in high doses.

Now, all medications have side effects, so communicate with your physician about any side effects and concerns you have about your medications. Sometimes the dose or the time that you take them has to be adjusted, but don’t do this yourself, only with a physician’s permission.

To learn more about the side effects of anxiety medications and to know your level of anxiety, visit AnxietyBoss.com.