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I just posted this reply on another thread, but decided to start a new post just in case it may help someone else.
Well, I am currently in professional school right now (won't say which one) and we just covered the topic of anxiety, and the recommended treatment for it. For basic generalized anziety benzo'w ARE the mainstay of therapy and have much research/clinical studies supporting their use. While many of you have stated strong addictive behaviors of BENZO's, this is absolutely not true according to research. Basically, just about all forms of addiction have many components to it, but a certain characteristic to all addictive drugs is that they somehow affect/stimulate a certain neuronal pathway in the brain called the mesolimbic DA (dopamine) pathway, and increase DA release by these neurons. It has been studied and proven however that benzo's DO NOT affect this pathway when used alone. However, it is believed that the use of previous or concurrent medications can somehow make changes in this pathway leading to the ability of benzo's to stimulate it and cause reinforcing/addictive behaviors. The main drug studied that does this (increase benzo addiction likelihood) is alcohol, but I suspect many other drugs could also do this, even AS. For those of you that are experiencing addiction, it may be because of some of the pharmacokinetics of the drug, specifically the onset of action vs. duration of action. Quicker onset action drugs typically have more abuse potential while drugs that take longer to have an effect, and therefore, have a longer t1/2 and geater protection time, have less addiction.
For GAD (generalized anxiety disorder) - simply, anxiety consistently with no real definitive cause or many different triggers, I would recommend a longer acting drug such as Diazepam (b/c of active metabolite), clonazepam, or prazepam and would take this medication consistently on a daily basis. Initial side effects can be tough such as sedation and amnesia (which makes concentrating/studying difficult), and sleep disturbances (decreased REM sleep which could lead to uninhibited or aggressive behaviour). For cases where the anxiety is intermittent (doesn't occur all the time) then a shorter acting agent such as oxazepam, lorazepam, or alprazolam could be used on an as needed basis when the anxiety occurs. If taken long enough, all of the initial side effects will resolve (which is why they aren't affective for long term sleep disorders or as anticonvulsants - except clonazepam), except for their anti-anxiety effect, which continues to occur and doesn't develop tolerant effects.
These benzodiazepines work by modulating GABA-A receptor function in the brain and making it easier for GABA to bind and open the channel so that Cl- can flow into the cell, therefore hyperpolarizing the cell. This helps to cause sedative (calming) effects in an "aroused" person with anxiety.
Another class of drugs called the "non-benzodiazepine anxiolytics" are decently new with the main drug buspirone (buspar) being studied the most. This class seems to have less side effects than the traditional benzodiazepines. These drugs are 5-HT1A receptor (a receptor that binds serotonin) partial agonists. They work to modulate 5-HT (serotonin) and DA (dopamine) transmssion in the brain which has some how gotten "out of wack" (pardon the slang) in patients with anxiety, and even depression. Therefore, this drug helps to correct these irregularities. Buspar must be taken on a daily basis, and like most anti-depressants, they take several weeks to work, therefore don't expect an immediate responce. These drugs are currently the mainstay treatment for patients with MADD or mixed anxiety-depressive disorder. Where the patients experience symptoms of both depression and anxiety.
Beta-Blockers as also used to treat a certain anxiet called "performance anxiety". As it sounds, this is anxiety that people get when the must perform (such as give speaches, talk in front of lots of people, etc) normally in front of a large crowd, and they get the sympathetic "flight" responce. In other words, their heart rate increases, they get sweaty palms, etc. If the B-Blocker (most common is propranolol) is taken just prior to the performance, it will block most of these responces, and help the individual "perform" much better.
I generally don't recommend herbal products and things like that simply b/c there is not much regulation governing their products. The manufactures can make certain claims of benefit, without no real proof/clinical studies, and there is no guarantee that what is in the bottle is what is advertised to be (sort of like IP products-kidding) For this main reason I tend not to recommend these supplements.
I also was not told anything about this OTC product some on this board have recommended called inositol. I know inositol is a 2nd messenger important for cascade of events that occur within the cell, but I have no clue how it may help relieve anxiety.. All I do know is that I've been tought most of what I have told you from a research oriented school, and I am sure that if there were good/hard/proven evidence for it's use, then it would have been brought up in class.
Well thats just about my 3 million cents (haha) on anxiety, and I hope it helps some of you out. If you have any questions, please feel free to PM me, and I will help if I can.
Peace
Well, I am currently in professional school right now (won't say which one) and we just covered the topic of anxiety, and the recommended treatment for it. For basic generalized anziety benzo'w ARE the mainstay of therapy and have much research/clinical studies supporting their use. While many of you have stated strong addictive behaviors of BENZO's, this is absolutely not true according to research. Basically, just about all forms of addiction have many components to it, but a certain characteristic to all addictive drugs is that they somehow affect/stimulate a certain neuronal pathway in the brain called the mesolimbic DA (dopamine) pathway, and increase DA release by these neurons. It has been studied and proven however that benzo's DO NOT affect this pathway when used alone. However, it is believed that the use of previous or concurrent medications can somehow make changes in this pathway leading to the ability of benzo's to stimulate it and cause reinforcing/addictive behaviors. The main drug studied that does this (increase benzo addiction likelihood) is alcohol, but I suspect many other drugs could also do this, even AS. For those of you that are experiencing addiction, it may be because of some of the pharmacokinetics of the drug, specifically the onset of action vs. duration of action. Quicker onset action drugs typically have more abuse potential while drugs that take longer to have an effect, and therefore, have a longer t1/2 and geater protection time, have less addiction.
For GAD (generalized anxiety disorder) - simply, anxiety consistently with no real definitive cause or many different triggers, I would recommend a longer acting drug such as Diazepam (b/c of active metabolite), clonazepam, or prazepam and would take this medication consistently on a daily basis. Initial side effects can be tough such as sedation and amnesia (which makes concentrating/studying difficult), and sleep disturbances (decreased REM sleep which could lead to uninhibited or aggressive behaviour). For cases where the anxiety is intermittent (doesn't occur all the time) then a shorter acting agent such as oxazepam, lorazepam, or alprazolam could be used on an as needed basis when the anxiety occurs. If taken long enough, all of the initial side effects will resolve (which is why they aren't affective for long term sleep disorders or as anticonvulsants - except clonazepam), except for their anti-anxiety effect, which continues to occur and doesn't develop tolerant effects.
These benzodiazepines work by modulating GABA-A receptor function in the brain and making it easier for GABA to bind and open the channel so that Cl- can flow into the cell, therefore hyperpolarizing the cell. This helps to cause sedative (calming) effects in an "aroused" person with anxiety.
Another class of drugs called the "non-benzodiazepine anxiolytics" are decently new with the main drug buspirone (buspar) being studied the most. This class seems to have less side effects than the traditional benzodiazepines. These drugs are 5-HT1A receptor (a receptor that binds serotonin) partial agonists. They work to modulate 5-HT (serotonin) and DA (dopamine) transmssion in the brain which has some how gotten "out of wack" (pardon the slang) in patients with anxiety, and even depression. Therefore, this drug helps to correct these irregularities. Buspar must be taken on a daily basis, and like most anti-depressants, they take several weeks to work, therefore don't expect an immediate responce. These drugs are currently the mainstay treatment for patients with MADD or mixed anxiety-depressive disorder. Where the patients experience symptoms of both depression and anxiety.
Beta-Blockers as also used to treat a certain anxiet called "performance anxiety". As it sounds, this is anxiety that people get when the must perform (such as give speaches, talk in front of lots of people, etc) normally in front of a large crowd, and they get the sympathetic "flight" responce. In other words, their heart rate increases, they get sweaty palms, etc. If the B-Blocker (most common is propranolol) is taken just prior to the performance, it will block most of these responces, and help the individual "perform" much better.
I generally don't recommend herbal products and things like that simply b/c there is not much regulation governing their products. The manufactures can make certain claims of benefit, without no real proof/clinical studies, and there is no guarantee that what is in the bottle is what is advertised to be (sort of like IP products-kidding) For this main reason I tend not to recommend these supplements.
I also was not told anything about this OTC product some on this board have recommended called inositol. I know inositol is a 2nd messenger important for cascade of events that occur within the cell, but I have no clue how it may help relieve anxiety.. All I do know is that I've been tought most of what I have told you from a research oriented school, and I am sure that if there were good/hard/proven evidence for it's use, then it would have been brought up in class.
Well thats just about my 3 million cents (haha) on anxiety, and I hope it helps some of you out. If you have any questions, please feel free to PM me, and I will help if I can.
Peace
