What Works For Anxiety Disorders–Anti-Anxiety Drugs
|Short-term use (up to four weeks)||Our rating||Long-term use||Our rating|
|PTSD and ASD||PTSD and ASD|
|Social Phobia||Social Phobia|
|Panic Disorder and Agoraphobia||Panic Disorder and Agoraphobia|
|Specific Phobias||Specific Phobias|
WHAT ARE THEY?
Anti-anxiety drugs are used mainly for short-term, intense anxiety. They may also be known as tranquilisers, anxiolytics or ‘benzos’, since benzodiazepines (BZDs) are the largest group of anti-anxiety drugs. Common types of anti-anxiety drugs include alprazolam, clonazepam, diazepam and oxazepam. These drugs can be prescribed only by a doctor.
HOW ARE THEY MEANT TO WORK?
Anti-anxiety drugs work on brain nerve cells. These drugs tend to work very fast in reducing anxiety symptoms.
DO THEY WORK?
A review of a number of good quality studies found that BZDs are generally more effective than placebo (dummy) pills in reducing anxiety symptoms. However, most studies only lasted for four weeks. This suggests that these drugs are only effective in the short term. Longerterm use of BZDs does not appear to be helpful. This is because most patients do not recover from GAD when taking these drugs on their own.
PTSD and ASD
Only one good-quality study has compared a BZD to placebo in a small trial of 16 adults. The BZD was no better than the placebo in improving PTSD symptoms over the five weeks of the study.
Three good-quality studies have compared a BZD to a placebo in Social Phobia. All found that the BZD was better than the placebo in the short term (e.g. under three months). However, there is no information on whether they are useful over longer periods of time.
Panic Disorder and Agoraphobia
A number of good-quality studies have compared BZDs with a placebo pill for the treatment of Panic Disorder (with and without Agoraphobia). These studies show that BZDs are more effective than a placebo in reducing panic attacks and anxiety in the immediate or short term. However, they are not as effective as other drugs (e.g. antidepressants), especially in the longer term.
Two good-quality studies have compared a BZD to a placebo in people with Specific Phobias. In both studies, the BZD was better than the placebo in reducing immediate anxiety levels. However, both studies showed poor outcomes when used over a longer period of time. After one week or three months, anxiety levels in the BZD groups had either returned to pre-treatment levels, or become worse.
One study compared a BZD to a placebo in 27 adults with OCD. Only three people had improved after 10 weeks of treatment. Overall, the BZD was not more effective than the placebo.
ARE THERE ANY RISKS?
Long-term use of anti-anxiety drugs can cause addiction and usually the person develops tolerance to many of the medication effects. There can also be a range of side-effects, including memory loss, sleepiness, dizziness and headache.
There is evidence that anti-anxiety drugs are effective in the short term only for reducing symptoms of Panic Disorder, GAD and Social Phobia, but not for PTSD and Specific Phobias. However, they are
not recommended as a long-term treatment for anxiety disorders. This is because they have a risk of addiction, and may cause memory problems. If anti-anxiety drugs are used, they should only be taken for a short period of time to avoid addiction.
Source: Reavley NJ, Allen NB, Jorm AF, Morgan AJ, Purcell R. A Guide to What Works for Anxiety Disorders. beyondblue: Melbourne, 2010.
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