Limitations of medications for treating anxiety

Conventional treatments anxiety in Western culture include a specialized kind of therapy called cognitive-behavioral therapy (CBT), supportive psychotherapy, and medications. Studies have confirmed that certain medications such as benzodiazepines (e.g. lorazepam, clonazepam and others) and serotonin reuptake inhibitors (SRIs) are effective for the short-term management of both panic attacks and generalized anxiety. Some medications are beneficial for symptoms of social phobia however available medications are not effective against fear of spiders (‘arachnophobia’), fear of heights, fear of flying and other so-called specific phobias. Certain kinds of behavioral therapies including graded exposure and flooding sometimes reduce the severity of social anxiety and performance anxiety. Conventional Western approaches used to treat symptoms of obsessive-compulsive disorder and post-traumatic stress disorder (PTSD) often combine psychotherapy and prescription medications.

A review of the medical research literature confirms that most currently available conventional treatments of anxiety are sometimes beneficial but have limited efficacy overall. A meta-analysis of several high-quality studies concluded that the efficacy of conventional treatments varies widely depending on the core symptom being treated. Panic attacks tend to improve and remain improved in response to sedative-hypnotic medications like lorazepam and clonazepam, but patients who use these and related medications for a period of time to control panic symptoms are at significant risk of benzodiazepine dependence and withdrawal. Furthermore, most individuals who experience generalized anxiety initially respond well to such conventional treatments but continue to have anxiety problems over the long-term. Phobias, obsessions and compulsions, and symptoms of post-traumatic stress are often poorly responsive to conventional pharmacologic treatments. Furthermore, many patients who have these problems are too impaired to seek treatment and often have other mental health problems such as depressed mood, insomnia and are at risk of abusing alcohol or drugs. Finally, anxiety is difficult to treat because of differences in the type and severity of symptoms in different people as well as medical, psychological, social and cultural factors that often cause anxiety or make a pre-existing anxiety problem worse.

The limitations of available conventional pharmacologic and psychotherapy treatments of anxiety disorders invite rigorous open-minded consideration of the range of complementary and alternative approaches. You can find out about safe and effective non-pharmacologic treatments of anxiety in “Anxiety: the Integrative Mental Health Solution,” by James Lake M.D.

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