Anti-Anxiety and Sedative/Sleep Medicines

Anti-Anxiety and Sedative/Sleep Medicines
Although the antidepressants are quite eff ective in the management of chronic
and long-term anxiety, they do not help immediately. In contrast, the antianxiety
medications, which consist primarily of the benzodiazepine compounds
such as Valium, Librium, Ativan, and Xanax, are eff ective soon aft er a
single dose is taken. Th ese medications are ideal for short-term, acute anxiety.
While they are very safe for short-term use, they can be quite sedating, which
limits their utility for exams or musical performances. Further, these medicines
are addicting when used regularly for extended periods of time. Th ese
medications can be quite eff ective in the short-term management of insomnia,
especially when anxiety is a main contributor to the sleep diffi culties. Th e differences
among the drugs in this class mostly derive from diff erent rates of
absorption and metabolism/excretion.
Th ere are some other medicines marketed or used for anxiety. Buspar
(buspirone hydrochloride) is an anti-anxiety medicine eff ective with mild
to moderate anxiety. Because it takes several weeks to work, it is used infrequently.
Th e beta-blocker Inderal is quite helpful for performance anxiety but should be used with caution because it can cause fatigue and has a potential to
decrease blood pressure.
Several medicines are marketed specifi cally for short-term insomnia and
are in the benzodiazepine class. Among the nonbenzodiazepine sleep medicines
are Ambien and Sonata. Ambien is quite eff ective, but because it stays
in the body for a fairly long time, it should be taken early in the night; it may
cause fatigue early in the morning. Sonata, which has a much shorter eff ect,
is a good medicine for people who have initial insomnia or who must be alert
soon aft er awakening. It is less helpful for those experiencing early morning
awakening.