Which medications are most effective for treating anxiety disorders. How do antidepressants and anti-anxiety drugs work. What are the potential side effects of anxiety medications. When should you consider medication for anxiety.

Understanding Anxiety Disorders and Treatment Options

Anxiety disorders encompass a range of conditions characterized by excessive worry, fear, and related behavioral disturbances. While symptoms vary among different types of anxiety disorders, effective treatment often involves a multi-faceted approach. Dr. Ken Duckworth, chief medical officer for the National Alliance on Mental Illness (NAMI) and assistant professor of psychiatry at Harvard Medical School, recommends a three-pronged strategy: psychotherapy, exercise, and medication.

The optimal combination and sequence of these elements may differ for each individual. Some patients may find relief through psychotherapy alone, while others might require medication to fully engage in therapy or to muster the energy for regular exercise. In some cases, a combination of multiple medications may be necessary to achieve the desired therapeutic effect.

Types of Medications Used to Treat Anxiety Disorders

Several classes of medications are commonly prescribed for anxiety disorders. These include:

• Antidepressants
• Benzodiazepines
• Buspirone
• Hydroxyzine
• Beta-blockers

Each category of medication works differently and offers unique benefits and potential side effects. Let’s explore these options in more detail.

Antidepressants: The First Line of Defense Against Anxiety

Antidepressants, particularly Selective Serotonin Reuptake Inhibitors (SSRIs), are often the initial medication prescribed for anxiety disorders. These drugs target serotonin, a neurotransmitter linked to mood regulation.

Dr. Beth Salcedo, medical director of the Ross Center for Anxiety & Related Disorders, notes that SSRIs can be highly effective in treating anxiety disorders for many individuals. While the exact mechanism by which SSRIs alleviate anxiety is not fully understood, these medications are non-addictive, unlike benzodiazepines.

Common SSRIs Used for Anxiety

• Fluoxetine (Prozac or Sarafem)
• Citalopram (Celexa)
• Sertraline (Zoloft)
• Paroxetine (Paxil, Paxeva, or Brisdelle)
• Escitalopram (Lexapro)

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Another class of antidepressants commonly used for anxiety disorders is SNRIs. Examples include:

• Venlafaxine (Effexor)
• Duloxetine (Cymbalta)

Both SSRIs and SNRIs may cause side effects such as nausea, nervousness, dizziness, reduced sexual desire, insomnia, and changes in weight. It’s important to note that these medications typically take four to six weeks or longer to reach full effectiveness.

Benzodiazepines: Fast-Acting Anxiety Relief

Benzodiazepines provide rapid anxiety relief by enhancing the activity of a specific neurotransmitter in the brain, producing a sedative effect. These medications are particularly useful for managing generalized anxiety disorder, panic disorder, and social anxiety disorder.

Due to their quick-acting nature and the potential for developing tolerance, benzodiazepines are typically prescribed for short periods, usually no more than a month. It’s crucial to follow your doctor’s instructions when discontinuing these medications, as abrupt cessation can lead to withdrawal symptoms.

Commonly Prescribed Benzodiazepines

• Alprazolam (Xanax or Niravam)
• Clonazepam (Klonopin)
• Lorazepam (Ativan)
• Diazepam (Valium)

Side effects of benzodiazepines may include drowsiness, dizziness, nausea, blurred vision, and confusion. While these medications can be powerful tools in managing anxiety, they require careful use under medical supervision due to their potential for addiction.

Alternative Medications for Anxiety Management

In addition to antidepressants and benzodiazepines, other medications may be prescribed to manage anxiety disorders:

Buspirone (BuSpar)

Buspirone is typically used to treat generalized anxiety disorder and is often prescribed in combination with an antidepressant. Side effects may include dizziness, headaches, nausea, and nervousness.

Beta-Blockers

Some individuals with specific phobias or panic disorders may benefit from beta-blockers. These medications can help manage the physical symptoms of anxiety, such as rapid heartbeat and trembling.

The Importance of Personalized Treatment Plans

When it comes to treating anxiety disorders, there’s no one-size-fits-all solution. Different individuals may respond better to certain medications or combinations of treatments. It’s not uncommon for patients to try several medications before finding the most effective option.

Are there factors that influence medication choice? Indeed, several considerations come into play when selecting an anxiety medication:

• The specific type of anxiety disorder
• Severity of symptoms
• Presence of co-occurring conditions
• Patient’s medical history and current medications
• Potential side effects and interactions

Collaborating closely with your healthcare provider is crucial in developing a tailored treatment plan that addresses your unique needs and circumstances.

Integrating Medication with Other Anxiety Management Strategies

While medication can play a vital role in managing anxiety disorders, it’s often most effective when combined with other therapeutic approaches. How can patients maximize the benefits of their anxiety treatment?

1. Engage in psychotherapy: Cognitive-behavioral therapy (CBT) and other forms of talk therapy can help patients develop coping strategies and address underlying issues contributing to their anxiety.
2. Prioritize regular exercise: Physical activity has been shown to have significant anxiety-reducing effects and can complement medication treatment.
3. Practice stress-reduction techniques: Mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help manage anxiety symptoms.
4. Maintain a healthy lifestyle: Proper nutrition, adequate sleep, and limiting caffeine and alcohol intake can support overall mental health.
5. Build a support network: Connecting with friends, family, or support groups can provide valuable emotional support during treatment.

Monitoring and Adjusting Anxiety Medication

Once you’ve started an anxiety medication, how do you know if it’s working effectively? What signs should prompt a discussion with your healthcare provider?

Key indicators to monitor include:

• Changes in anxiety symptoms (frequency, intensity, duration)
• Emergence of side effects
• Impact on daily functioning and quality of life
• Any new physical or emotional symptoms

It’s essential to maintain open communication with your healthcare provider throughout your treatment journey. They can help assess your progress, address any concerns, and make necessary adjustments to your medication regimen.

Navigating Potential Challenges with Anxiety Medications

While anxiety medications can be highly effective, they may present certain challenges. How can patients address common issues that arise during treatment?

Managing Side Effects

If you experience troublesome side effects, don’t hesitate to discuss them with your doctor. They may be able to adjust your dosage, switch to a different medication, or suggest strategies to mitigate the side effects.

Addressing Concerns About Dependency

Some patients may worry about becoming dependent on their anxiety medication, particularly when prescribed benzodiazepines. Your healthcare provider can explain the risks and benefits of your specific medication and work with you to develop a safe, effective treatment plan.

Dealing with Treatment-Resistant Anxiety

In some cases, anxiety symptoms may persist despite medication. What options are available for treatment-resistant anxiety?

• Trying different medications or combinations
• Exploring alternative therapies, such as transcranial magnetic stimulation (TMS)
• Intensifying psychotherapy approaches
• Considering holistic treatments to complement traditional medicine

Remember, finding the right treatment approach may take time and patience. Persistence and open communication with your healthcare team are key to achieving optimal results.

The Future of Anxiety Treatment: Emerging Therapies and Research

As our understanding of anxiety disorders continues to evolve, researchers are exploring new avenues for treatment. What promising developments are on the horizon for anxiety management?

Novel Pharmacological Approaches

Scientists are investigating new classes of medications that target different neurotransmitter systems or neural pathways involved in anxiety. These could potentially offer more targeted treatment options with fewer side effects.

Personalized Medicine

Advances in genetic testing and neuroimaging may soon allow for more personalized treatment plans, helping healthcare providers predict which medications are most likely to be effective for individual patients.

Digital Therapeutics

Mobile apps and virtual reality platforms are being developed to deliver cognitive-behavioral therapy and other interventions, potentially increasing access to treatment and providing support between clinical visits.

Neuromodulation Techniques

Non-invasive brain stimulation methods, such as transcranial magnetic stimulation (TMS), are showing promise in treating anxiety disorders resistant to traditional therapies.

As research progresses, these innovative approaches may offer new hope for individuals struggling with anxiety disorders, potentially expanding the toolkit of effective treatments available to patients and healthcare providers alike.

Which Medications Are Best for Anxiety Disorders?

Each anxiety disorder has different symptoms, but Ken Duckworth, MD, the chief medical officer for the National Alliance on Mental Illness (NAMI) and an assistant professor of psychiatry at Harvard Medical School in Boston, says many people with these disorders can benefit from this three-pronged approach: psychotherapy, exercise, and medication.

Each person may need a different combination of these three elements, and in different sequences. “There’s no magic in the treatment of anxiety,” says Dr. Duckworth.

“Some people will get better with psychotherapy alone, while some people might need medication to help them concentrate better on the therapy. Anxiety and depression can decrease motivation to exercise, but medication may give you the energy to do it.” Also, says Duckworth, a patient may need more than one medication.

9 Foods That Help Or Hurt Anxiety

There are several types of medications used to treat anxiety disorders.

• Antidepressants
• Benzodiazepines
• Buspirone
• Hydroxyzine
• Beta blockers

Within each of these categories, there are subgroups of drugs that work differently and have their own benefits, risks, and possible side effects.

Antidepressants are often used as the first line of treatment.

In particular, SSRIs, or selective serotonin reuptake inhibitors, are the kind of antidepressant that is most often prescribed. They impact a neurotransmitter that has been linked to mood.

These medications often take four to six weeks, or longer, to be fully effective.

“They’re supereffective in treating anxiety disorders [for certain people],” says Beth Salcedo, MD, the medical director of the Ross Center for Anxiety & Related Disorders and a past board president of the Anxiety and Depression Association of America. It’s not known exactly how SSRIs work on serotonin to alleviate anxiety, says Dr. Salcedo, but what is known is that they’re not addictive like benzodiazepines are (though they can cause uncomfortable symptoms if people stop too abruptly).

It’s important to follow your doctor’s instructions when taking any prescription drug. Talk to your doctor if you’re concerned about the side effects of a medication or if the drug you’re taking doesn’t seem to be alleviating your symptoms.

Which Antidepressants Are Used for Anxiety?

The two classes of antidepressants most commonly used to treat anxiety disorders are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

Examples of SSRIs include:

• fluoxetine (Prozac or Sarafem)
• citalopram (Celexa)
• sertraline (Zoloft)
• paroxetine (Paxil, Paxeva, or Brisdelle)
• escitalopram (Lexapro)

Examples of SNRIs include:

• venlafaxine (Effexor)
• duloxetine (Cymbalta)

Common side effects of both SSRIs and SNRIs may include:

• Nausea
• Nervousness or restlessness
• Dizziness
• Reduced sexual desire
• Drowsiness
• Insomnia
• Weight gain or loss
• Headache
• Dry mouth
• Vomiting
• Diarrhea

Other antidepressants that may be prescribed for anxiety include:

• bupropion (Wellbutrin, Zyban, Aplenzin, Budeprion, or Buproban)

Some people respond better to some antidepressants rather than others. You may need to try a few different medications before you find one that works for you.

RELATED: Meditation’s Soothing Effects

Which Benzodiazepines Are Used for Anxiety?

Benzodiazepines help relieve anxiety by enhancing the activity of a neurotransmitter in the brain and generating a sedative effect. They work quickly, and can relieve anxiety for several hours.

They are usually prescribed for those with generalized anxiety disorder, panic disorder, and social anxiety disorder.

Because they work so quickly, and because people taking them can build up a tolerance that leaves them needing higher doses to feel better, doctors will prescribe them for very short periods of time — usually no more than a month.

Unfortunately, people can become addicted to benzodiazepines, even in a short period of time. If you stop taking them suddenly, withdrawal symptoms may occur, so it’s important to follow your doctor’s instructions for tapering off your medication.

They can also be used with antidepressants initially while antidepressants take time to work.

“They’re a powerful tool,” says Duckworth, “but you have to be really smart about their use.”

Commonly prescribed benzodiazepines include:

• alprazolam (Xanax or Niravam)
• clonazepam (Klonopin) 
• lorazepam (Ativan)
• diazepam (Valium)

Other side effects of benzodiazepines may include:

• Drowsiness
• Dizziness
• Nausea
• Blurred vision
• Headache
• Confusion
• Tiredness or fatigue
• Nightmares

What Other Medications Are Prescribed for Anxiety?

Buspirone (BuSpar) is typically used to treat generalized anxiety disorder. It is often prescribed with an antidepressant.

Side effects of buspirone may include:

• Dizziness
• Headaches
• Nausea
• Nervousness
• Light-headedness
• Trouble sleeping

Some people with phobias or panic disorder may be prescribed a heart medication known as a beta blocker. These drugs are primarily prescribed for uneven heartbeat and high blood pressure, but they have been found to be helpful for treating the feelings that come with high-pressure situations.

“Beta blockers can be very helpful but in a limited way,” says Dr. Salcedo. “They are most commonly used for performance anxiety. They are really good for the physical symptoms such as heart racing, sweating, and shakiness, but they work less well for the anxious thoughts that might be causing the symptoms.”

Beta blockers are prescribed to be used on an as-needed basis; they’re not taken long-term.

Hydroxyzine (Atarax and Vistaril) is another medication prescribed for anxiety.

It’s an antihistamine that’s used to treat allergic reactions, but it also works to decrease activity in the brain.

These medications act quickly, like benzodiazepines, but unlike benzodiazepines, they don’t cause addiction.

Additional reporting by Carlene Bauer.

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What Is Generalized Anxiety Disorder (GAD)?

How Common Is Generalized Anxiety Disorder?

Generalized anxiety disorder affects 2.7 percent of the U.S. adult population in any given year, according to the National Institute of Mental Health (NIMH). And it’s about 75 percent more common in women than men.

Realizing you’re not alone may be one of the first steps you take toward dealing with your anxiety. “The first thing I do is tell patients that treatment is out there and it does work. And then I tell them that I’ve seen this a lot, which makes them feel better,” says Beth Salcedo, MD, the medical director of The Ross Center in Washington, DC, and the past board president of the Anxiety and Depression Association of America.

RELATED: 5 Quick Stress-Reducing Yoga Poses

What Causes Generalized Anxiety Disorder?

The exact causes of generalized anxiety disorder are unknown. Risk factors for GAD may include:

• Genetics Anxiety disorders are known to run in families.
• Brain Structure and Activity Researchers believe that differences in the areas that regulate stress and anxiety may contribute to the disorder.
• Traumatic Events Experiencing trauma, such as childhood abuse, may trigger the condition.
• Chronic Health Conditions Having a chronic medical condition may increase the risk of GAD.

Women who are pregnant may also experience generalized anxiety disorder — and possibly at a higher rate than the general population. It’s estimated that 8.5 to 10.5 percent of women will suffer from GAD during pregnancy, and that 4.4 to 10.8 percent of women will have it postpartum, according to a study from 2015.

If you feel that you’re suffering from generalized anxiety disorder during this time, it’s important to talk with your doctor about symptoms and whether you need treatment. Your doctor will discuss the risks and benefits of taking medication, if that becomes necessary.

How Is Generalized Anxiety Disorder Diagnosed?

As with other anxiety disorders, there’s no specific test to diagnose generalized anxiety disorder.

Your doctor may conduct a physical examination and order blood tests to rule out other possible causes of your symptoms.

A diagnosis of generalized anxiety disorder is based on both your psychological and physical symptoms.

According to the American Psychiatric Association’s diagnostic criteria, you have GAD if you’ve had difficult-to-control, excessive worry about numerous events or activities more often than not for at least six months, and if you have experienced at least three of the following six anxiety symptoms:

• Restlessness or edginess
• Becoming easily fatigued
• Difficulty concentrating, or feeling as if your mind has gone blank
• Irritability
• Muscle tension
• Sleep issues

Your symptoms must also be severe enough to cause significant distress or impair your ability to go about your daily life, and must not be due to substance abuse or other disorders or health issues.

What Is the Treatment for Generalized Anxiety Disorder?

The two main treatments for GAD are psychotherapy and medications. Your doctor may prescribe a combination of treatments.

Therapists often use an approach called cognitive behavioral therapy, or CBT, to treat generalized anxiety disorder.

This popular form of therapy, which is used for a variety of psychological disorders, helps people identify, understand, and change the thoughts and behaviors that contribute to their condition, according to the National Alliance on Mental Illness (NAMI).

Your doctor might first prescribe an antidepressant (which can also be effective for anxiety) to help with your symptoms, and tell you that it may take four to six weeks to start feeling the effects, says Ken Duckworth, MD, the chief medical officer for NAMI and an assistant clinical professor of psychiatry at Harvard Medical School in Boston.

Your doctor may also work with you to figure out whether to up your dosage or add a second medication; often, one medication can enhance the effects of the other or mitigate its side effects.

A number of different medications may be used to treat GAD, including:

• Antidepressants such as sertraline (Zoloft), fluoxentine (Prozac), duloxetine (Cymbalta), escitalopram (Lexapro), or paroxetine (Paxil)
• An anti-anxiety drug such as buspirone (Buspar)
• Benzodiazepines such as lorazepam (Ativan), diazepam (Valium), or alprazolam (Xanax)

Antidepressants are a first-line treatment for GAD.

Benzodiazepines should only be prescribed for a short time. Unlike antidepressants, they can become addictive even after a short period of time.

RELATED: Which Medications Are Best for Anxiety Disorders?

You may also find some relief through mindfulness-based exercises like meditation, says Dr. Salcedo. Research suggests that these therapies can be helpful in alleviating anxiety symptoms.

Deep-breathing exercises may also help.

Exercising, too, is important in treating and managing anxiety, even as anxiety may make you less inclined to want to workout. According to some studies, regular exercise works as well as medication to reduce symptoms of anxiety in some people.

Among the benefits, according to Harvard Medical School: moving your body decreases muscle tension; upping your heart rate can change your brain chemistry, increasing the availability of anti-anxiety neurochemicals; and exercise activates the part of the brain responsible for executive function, helping to control the amygdala, the part of the brain that is central to our experience of fear.

RELATED: How Meditation Can Improve Your Mental Health

Additional reporting by Carlene Bauer.

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top-5 rating according to KP

Everyone knows the phrase “all diseases are from nerves”. Indeed, prolonged stress undermines our health, reduces immunity. As a result of constant failures, diseases to which a tendency has been observed develop. For example, if you have relatives with hypertension, you have a high risk of developing the disease after prolonged stressful conditions.

Short-term stress and emotional outbursts usually do no harm. Much more dangerous is the sluggish nervous tension that often occurs among residents of megacities. Lack of sleep, city noise, worries at work lead to prolonged, but unnoticed depression, fatigue, mood and sleep disorders. This can drag on for years, until the person “breaks loose”, falling into a panic or aggressive state.

Many people unknowingly develop bad habits such as smoking and drinking alcohol to relieve stress. Toxic substances exacerbate the situation.

You can keep your nervous system healthy in other ways. Go in for sports, walk in the fresh air, consult a psychotherapist, take supportive drugs.

Top 5 list according to KP version

Bifistim Antistress

Did you know that the right balance of intestinal microflora also plays an important role in brain function? The fact is that in the course of its life activity, the beneficial microbiota releases a number of substances that affect the human nervous system, mood and cognitive abilities.

Bifistim Antistress probiotic contains Lactobacillus plantarum (DR7) complex. These beneficial lactobacilli suppress the production of the “stress hormone” cortisol, which can reduce anxiety and irritability. Also, the probiotic affects the production of serotonin and dopamine – the so-called “hormones of happiness”, which contribute to a good mood, as well as support mental work and memory. And magnesium and vitamin B6 as part of dietary supplements enhance the anti-stress effect and can have a beneficial effect on the nervous system of the body.

“Bifistim Antistress” is available in the form of capsules that can be taken once a day for a month.

Contraindications: individual sensitivity to components, pregnancy, lactation.

Lactobacilli in the composition of probiotics suppress the production of the “stress hormone” cortisol and affect the production of the “happiness hormones” serotonin and dopamine, magnesium and vitamin B6 help maintain the nervous system.

Not recommended during pregnancy and lactation; cumulative effect.

Bifistim Antistress

Antistress Probiotic

Bifistim Antistress Probiotic helps reduce the effects of stress on the body and support intellectual functions.

Find out the priceStudy the composition of

dietary supplement. NOT A DRUG

Advertisement ZAO PharmFirma Sotex. Their accumulation has a very mild calming effect and can be useful for minor anxiety as an additional support for the body.

In case of severe stress and its physical manifestations, the remedy may not work immediately. Sometimes you have to take pills for more than a week to notice the effect.

Natural composition; no side effects; does not cause addiction and drowsiness; low price

Cumulative effect; not allowed under 18 years of age; not during pregnancy and lactation

Emotocin

Physical health and emotional balance are closely related. Constant nervous tension adversely affects the immune system, and subsequent health problems add even more negativity. Emotocin can help break this vicious circle.

A distinctive feature of “Emotocin”, its basis, is sodium deoxyribonucleate – a natural substance that is used primarily to naturally strengthen the immune system and protect against viruses. It is known that it is also used during the period of increasing incidence of acute respiratory infections, acute respiratory viral infections, to maintain the normal functioning of the immune system, fight viruses, and regenerate mucous membranes damaged by viruses. And B vitamins are traditionally used to recover from increased physical and emotional stress, to increase vitality and optimize the body’s metabolic processes.

Pleasant-tasting tablets are easy to swallow and dissolve in the mouth, and the economical packaging lasts for a long time.

Contraindications: individual intolerance to substances in the composition.

Dual action: helps to protect the body from stress and naturally supports the immune system; few contraindications; convenient to take; easy to buy on marketplaces and online pharmacies.

Not always available in a pharmacy.

Emotocin

Protecting the body from stress and viruses

A complex for an adequate response to daily stress and maintaining immunity.

Where to buy Ozon

dietary supplement. IS NOT A MEDICINE.

Advertising. Pharmpack LLC. LjN8KC887

Not only some of the active substances in dietary supplements, but also medicines are designed to help in the fight against stress.

Glycine tablets

Tablets contain the active ingredient of the same name. This drug can be prescribed as an additional support for the brain with constant overstrain: stressful work, difficult studies. Tablets help to regulate metabolism and can improve the processes of inhibition in the central nervous system. This reduces tension and aggression. It is, however, quite affordable.

Also, the drug is able to reduce the effects of brain injuries, alcohol or drug poisoning.

Helps increase mental performance; improve sleep; no side effects; possible during pregnancy and children; low price

Accumulative effect, does not act immediately

Afobazole

This drug belongs to tranquilizers and antidepressants. It is indicated for anxiety, attacks of fear, sleep disorders. And it can also alleviate the course of many diseases: asthma, hypertension, arrhythmias.

The drug is indicated for vulnerable, suspicious people prone to tearfulness or irritability. Taking pills helps to endure premenstrual syndrome, as well as the “withdrawal syndrome” with a sharp rejection of bad habits, smoking and alcohol.

Fights anxiety and other nervous disorders; does not cause lethargy and addiction; practically no side effects.

Not allowed under 18; not during pregnancy and lactation; cumulative effect, does not appear immediately; high price.

How to choose pills for stress and nerves

Even light sedatives should not be prescribed by yourself. Most likely, they will not cause direct harm, but they can “blur” the picture of the course of a nervous disease. You may actually need a different type of medication and psychotherapy sessions. Therefore, it is better to consult a neurologist or a psychotherapist.

“The remedy must be chosen according to the problems. If you experience “bodily anxiety” – a feeling of tingling in the body, a coma in the throat, a feeling of lack of air, pressing pains and tightness behind the sternum, it is better to choose drugs with the properties of a vegetative stabilizer. They stabilize that part of the nervous system that is responsible for the activity of organs and blood vessels. Disorder in the work of the autonomic nervous system due to stress can cause discomfort in the body,” says neurologist Irina Ignatova .

Additionally, you can take various nootropics – drugs that stimulate the brain. This will help him cope with complex mental work and recover faster.

For mental anxiety, obsessions, difficulty falling asleep, sedatives are suitable: homeopathic remedies or plant-based sedatives. They suppress the excessive activity of the central nervous system and soothe.

Photo: market.yandex.ru

Ineffective sedatives, ineffective anti-anxiety drugs, side effects

Medicine and health

11/14/22

Daniil Davydov

medical journalist

Author profile

Many people now experience anxiety, and it can be difficult to cope with it on your own. About what ways can really help, we wrote in the article “5 tips on how to cope with anxiety in difficult times.”

However, some popular medications and supplements that are marketed as anti-anxiety medications have no evidence of effectiveness.

Some of them are relatively harmless, but others have side effects and contraindications, so under certain conditions they can do more harm than good. If you are planning to purchase a medication for anxiety, we recommend that you consult with your doctor. And this list will help you make an informed decision.

Essential skills in times of stress – WHO pictorial

What you will learn

• Novo-Passit
• Persen
• Corvalol
• Motherwort 901 40
• Validol
• Afobazol
• Tenoten

Go to the doctor

Our articles written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we give recommendations. Relying on our point of view or not is up to you.

Novo-Passit

What is it. Phytotherapeutic tablets or solution based on herbal extracts of valerian officinalis, lemon balm, hypericum perforatum, hawthorn, passionflower incarnate, common hop, black elderberry and guaifenesin

Novo-Passit – GRLS

According to the manufacturer, the drug helps with a state of constant mental stress and mild forms of insomnia.

Proof of effectiveness. Novo-Passit is not mentioned in international databases of medicines, nor is it in clinical recommendations for the treatment of any diseases.

14 reputable medical sources

Some drugs are made from chemicals derived from plants. For example, cardiac glycosides are made from digitalis purpurea. But for the manufacture of the drug, not the whole plant and not the extract from it are used, but separate, carefully purified chemicals, the concentration of which is very strictly controlled.

Products containing extracts or whole parts of one or more plants are classified as herbal medicine and are considered dietary supplements in most countries. Therefore, they are neither in international drug databases nor in clinical guidelines for the treatment of diseases.

What is Phytotherapy – MedlinePlus Medical Guide

There is no need to look for evidence of the effectiveness of dietary supplements, since by law it is just food.

All that is required of them is to be safe, that is, not to harm the health of the people who take them. Since it is not necessary to prove the effectiveness of herbal remedies, they are very poorly studied. When it comes to complex herbal remedies, research is further complicated by the fact that they do not work the way they would work separately.

They say expensive supplements are more effective than cheap ones. Is it true?

For example, although the European Medicines Agency, or EMA, considers valerian essential oil and rhizome preparations to have a calming effect, we do not know how this plant extract will work in combination with other plant extracts.

Valerian essential oils – EMA

Valerian rhizomes – EMA

Finding out how effective a multi-herb formulation works is also difficult because different researchers study different sets of herbal extracts at different concentrations. As a result, most scientists admit that we do not yet have reliable information on how effective herbal preparations based on herbs are for anxiety.

For example, psychotherapists in Switzerland who were trying to understand whether a combination of extracts of valerian, lemon balm, passionflower and butterbur helps with anxiety disorders. They gave part of the patients these supplements and compared the effect with patients who did not receive supplements, and came to the conclusion that the supplements can reduce the dosage of the main drugs – benzodiazepines.

Effect of a combination of valerian, lemon balm, passionflower and butterbur extracts on benzodiazepine prescribing in hospitalized patients with psychiatric disorders – Journal of Phytotherapy

These types of studies are called case-control studies. Even if they show that patients got better, this cannot be considered conclusive evidence of the effectiveness of the drug, since doctors knew who was receiving which drug and could unwittingly embellish the result. Patients who received supplements could also believe in their power and feel better – this is called the placebo effect.

To understand how well supplements really work, you need to study them the way you study drugs, that is, subject them to a randomized clinical trial. With this procedure, patients are randomly divided into two groups, one of which receives the drug, and the other receives exactly the same type of dummy pills, and neither doctors nor patients know which group they fell into until the end of the experiment. But there are still no such works devoted to supplements with herbal extracts for anxiety. Until they appear, nothing definite can be said about whether they work.

Another component of Novo-Passit, guaifenesin, is known mainly as a cough suppressant and expectorant. There is still no convincing evidence that guaifenesin helps with coughing – but it has quite a few side effects.

Guaifenesin – a cough remedy – drugs.com

I have not been able to find studies of guaifenesin as an anti-anxiety agent.

Contraindications and side effects. In the instructions, the manufacturer writes that Novo-Passit is contraindicated in children under 12 years of age and people with intolerance to the components of the drug – especially guaifenesin. As a rule, it is well tolerated, but some people complain of allergies, dizziness, weakness, drowsiness and gastrointestinal disorders – from vomiting and heartburn to diarrhea.

The cost of the drug depends on the number of tablets in the package and the volume of the vial A package of 10 tablets and a 100 ml solution bottle cost approximately the same – 460-470 R

Persen

What is it. Phytotherapeutic tablets and capsules based on the extract of rhizomes of valerian, lemon balm and mint.

Persen — GRLS

According to the manufacturer, the drug has a sedative effect.

Proof of effectiveness. Persen is not mentioned in the international drug databases, nor is it in the clinical recommendations for the treatment of any diseases. This is a phytotherapeutic drug similar to Novo-Passit, but with a slightly different composition. He has exactly the same problems with evidence of effectiveness.

Contraindications and side effects. According to the manufacturer, the drug should not be taken by people with hypersensitivity to its components, people with low blood pressure, diseases of the biliary tract, children under 12 years old, pregnant and lactating women. The drug can cause allergic reactions – from rashes to edema, and with prolonged use, provoke constipation.

The cost of the drug depends on the number of tablets in the package. The price of a pack of 20 tablets is 351 R

Corvalol

What is it. Corvalol is sold in two versions:

1. phytotherapeutic agent based on extracts of lemon balm leaves, peppermint and motherwort herb in tablets and water-based drops;
2. phytotherapeutic agent based on extracts of lemon balm leaves, peppermint, motherwort herb, which contains phenobarbital. These are drops based on 95% alcohol.

Corvalol tablets – GRLS

Corvalol drops with phenobarbital – GRLS

According to the manufacturers, Corvalol in both versions “has a calming effect.”

Proof of effectiveness. As an anxiety remedy, both versions of Corvalol, both with and without phenobarbital, are not mentioned in any international drug database. In clinical recommendations for the treatment of any diseases, they are also absent.

There is no convincing evidence that any of the components of Corvalol without phenobarbital can work as a sedative. According to some studies, lemon balm tea or tincture relieves insomnia, and the smell of peppermint can reduce stress a little. But there is no evidence that in tablets or drops these components will act in the same way as in the form of tea or essential oil.

Maybe lemon balm tea or tincture helps with insomnia — RxList

Maybe the smell of mint can relieve stress — RxList

Why phenobarbital is dangerous — drugs. com

At the same time, Corvalol with phenobarbital can really have a calming effect account, in fact, phenobarbital. This is a very old tranquilizer, in most countries its is prescribed only as an anticonvulsant and its use is strictly controlled, since phenobarbital is addictive and has many side effects.

Contraindications and side effects. Manufacturers of Corvalol without phenobarbital warn that it has quite a few contraindications: from allergies to its components to peptic ulcer, liver or kidney diseases, pregnancy and breastfeeding. Children under 18 years of age should not take the drug.

Manufacturers of Corvalol with phenobarbital add alcoholism and traumatic brain injury to the list of contraindications. Experts from other countries warn that phenobarbital is also contraindicated in severe asthma and chronic obstructive pulmonary disease, i.e. COPD, porphyria, and for people with a history of drug dependence in the past. The list of side effects of phenobarbital drops includes dizziness, weakness, nausea, decreased alertness, and rash.

14 important issues to the cardiologist Anton Rodionov

The cost of the drug depends on the number of tablets in the package, the volume of the bottle and on the pricing policy of the manufacturer and vary from 42 p for a bottle of 25 ml to 471 p for a package of 50 tablets

drugs and additives with motherwort

What is it. Phytotherapeutic agents based on motherwort extract. According to the manufacturers, such drugs have a pronounced sedative effect – that is, they work as a strong sedative.

Preparation based on motherwort extract — GRLS

Motherwort-based supplements registered in Russia

Motherwort as a source of bioactive compounds — European Medicines Agency report

Possibly motherwort in combination with others herbs improves sleep in people with alcoholism – medical reference book RxList

In Russia, there are both medicines and biologically active supplements based on motherwort – both in the form of liquid extracts and in capsules.

Proof of effectiveness. Motherwort-based preparations are not listed as an anxiety remedy in any international drug database. In clinical recommendations for the treatment of any diseases, it is also absent.

Theoretically, motherwort may have a potential neurological effect. Some substances in this plant can bind to receptors for gamma-aminobutyric acid, or GABA. This neurotransmitter is responsible for the inhibition of the nervous system, so the researchers suggested that the biologically active substances in motherwort would work in a similar way.

But when the substances in the motherwort extract that could work as sedatives were tested separately, their biological effect was very weak. Most likely, patients with anxiety would simply not feel its effects.

The effectiveness of motherwort remedies in healthy people with severe anxiety has not been tested. According to some studies, the combination of motherwort, valerian, hops, and lemon balm improves sleep in people with alcoholism who are trying to quit drinking. However, there is no conclusive evidence for this yet.

Contraindications and side effects. Motherwort preparation companies warn that some people may have allergies or digestive disorders – indigestion, that is, pain or discomfort in the stomach, and diarrhea.

Motherwort preparations and supplements are contraindicated in people taking neurological preparations based on calcium hydroxybutyrate, magnesium hydroxybutyrate, potassium hydroxybutyrate, or sodium hydroxybutyrate. Motherwort can enhance the effect of such drugs – up to severe poisoning and coma.

Motherwort is incompatible with hydroxybutyrates – Medscape Medical Guide

Some pharmaceutical companies offer motherwort extract based on 70% alcohol. According to the instructions, you need to use the drug in 30-50 drops diluted in water – the maximum content of ethyl alcohol in such a dose is 0.55 g, and in the maximum daily dose – 2.2 g.

International organizations believe that women can take no more than one standard serving of alcoholic beverages per day, and for men – no more than two servings. This is 14 g of pure ethanol.

Is it true that wine is good for the heart and helps you live longer?

The amount of ethyl alcohol that can be obtained with the maximum dose of the drug is much less than the standard serving of alcohol. Nevertheless, people who take drugs that are incompatible with alcoholic beverages, such as antidepressants, should, just in case, abandon the alcohol tincture of motherwort.

The cost of the drug depends on the pricing policy of the manufacturer. The cheapest package of 10 tablets can be bought for 18 R

Validol

What is it. Levomenthol sublingual tablets are a substance derived from peppermint essential oil.

Validol – GRLS

Manufacturers claim that this drug “has a sedative effect” – that is, it works as a sedative.

Proof of effectiveness. Levomenthol-based drugs are not listed as anti-anxiety drugs in any international drug database.

In some countries, levomenthol is approved only as an external agent for veterinary use. It is mainly used as a cough suppressant, anti-inflammatory and antipruritic drug in humans and animals.

Levomenthol — drugs.com

How levomenthol is used in medicine — PubChem chemical guide

No one has studied the effectiveness of peppermint essential oils and drugs with levomenthol for anxiety in people.

Contraindications and side effects. There are few contraindications for drugs with levomenthol: mostly it is an allergy or intolerance to the components of the drug, the medicine is not suitable for children under 18 years of age. But there are side effects: nausea, watery eyes and dizziness. According to the manufacturers, the drug is incompatible with alcohol.

The cost of the drug depends on the number of tablets in the package and on the pricing policy of the manufacturer. The cheapest package of 20 tablets costs 54 R

Afobazol

What is it. A drug based on a substance that received the international name fabomotizol. In our country, “Afobazol” of immediate and delayed action is sold. In the delayed-release preparation, the concentration of the active substance is three times higher, and it is absorbed during the day.

Afobazol – GRLS

According to the manufacturers, tablets with fabomotizol reduce anxiety and stimulate the nervous system.

Proof of effectiveness. Fabomotizole-based drugs are not listed as anti-anxiety drugs in any international drug database.

The effectiveness of “Afobazole” as a remedy for anxiety was studied only in Russia – the drug is not used anywhere else in the world. I could not find independent studies on the effectiveness of the active substance for anxiety.

Contraindications and side effects. Among the contraindications, the manufacturer lists only individual intolerance to the components of the drug, age under 18, pregnancy and the period of feeding a child. And among the side effects are allergies and headaches.

Immediate drug. Price: 720 Р Delayed action drug. As a rule, slow-acting drugs are more expensive. Price: 894 R

Tenoten

What is it. Lozenges based on lactose sugar. The composition of the drug intended for adults includes antibodies to the brain-specific S-protein at a concentration of 10 ^-15 ng/g, and in the children’s version – 10 ^-16 ng/g.

Tenoten for adults – GRLS

According to the manufacturer, it has a sedative and anti-anxiety effect.

Proof of effectiveness. The concentration of the active substance makes it possible to recognize Tenoten as a homeopathic remedy, since at a concentration of 10 ^-15 -10 ^-16 ng / g, not a single antibody may appear in the tablet. But even if there were more antibodies, manufacturer-independent data that antibodies to the brain-specific S-protein reduce anxiety, no.