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2021.12.07

Why are antidepressants used for treating anxiety?

It is not uncommon for adults and children to suffer from anxiety.
About twice as many women as men suffer from it.
Surprisingly, the first onset is early in childhood, adolescence, and early adulthood (Lancet, 2016).

It is important to note that anxiety is often overlooked because the symptoms of anxiety are mainly physical, such as pain, breathlessness, and insomnia, rather than a feeling of “anxiety.”

Children, in particular, are not yet at the developmental stage to recognize and verbalize their feelings of anxiety. Physical symptoms are often things like “tummy ache,” feeling “sick,” or “headaches.” Anxiety symptoms are also more likely to appear in behavioral symptoms such as anger and irritability among children.

There are basically two treatments for anxiety: medication and psychotherapy.

Today, I would like to talk about medication.

Sometimes people are surprised to be prescribed antidepressants called SSRIs or SNRIs for anxiety. They worry, “How can this doctor prescribe depression medication which they often consider to be ‘strong’ medication, for anxiety? Many patients often say, “I prefer ‘light’ medications such as anxiolytics and tranquilizers.

However, the truth is that both domestic and international evidence-based guidelines for the treatment of anxiety are consistent and often indicate therapy with antidepressants.

Although the benzodiazepine class of anti-anxiety drugs are effective and fast-acting, they are not recommended because they may cause dependence with continuous use, even at doses within the therapeutic range.

The recommended medications for anxiety are SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin and noradrenaline reuptake inhibitors).

SSRIs and SNRIs work by blocking the reuptake of neurotransmitters (serotonin and noradrenaline) released from the synaptic endings of nerve cells in the brain.

The targeted symptoms are anxiety, depression, and insomnia. However, SSRIs and SNRIs do not immediately reduce symptoms because they take about two weeks to become effective.

Many people are under the impression that the medications used for depression are “stronger” and that medications for anxiety are “weaker.”

SSRIs or SNRIs are the first-line therapy for the treatment of anxiety. In general, anti-anxiety medications (and sometimes a small amount of antipsychotic medication depending on the symptoms) are used.

There is a general misconception that antidepressants are not helpful for the treatment of anxiety. In fact, antidepressants are quite effective in treating anxiety and depression.

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