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When frazzled nerves turn into panic attacks, too much stress gets an official name: anxiety disorder. Forty-seven years ago, Valium became one of the first of a type of medications called benzodiazepines to hit pharmacy shelves. The drug dominated the market even before a Rolling Stones song immortalized it as “mother’s little helper.”
Today there are many other “benzos,” including Xanax, Klonopin, and Ativan, that doctors prescribe to treat anxiety. These drugs quiet overactive neurotransmitters in the brain. But many physicians are loath to use them long term because they can be addictive.
As medicine has revealed more about anxiety, the line between it and depression has blurred. Doctors now commonly prescribe antidepressants such as Lexapro, Paxil, and Zoloft for anxiety. These selective serotonin reuptake inhibitors—or SSRIs—maintain more of the brain’s serotonin, thereby lifting a patient’s mood.
Similar drugs known as SNRIs boost both serotonin and norepinephrine levels. Every person reacts differently to antidepressants, but weight gain and low libido are among an array of possible side effects.
The downsides don’t seem to be scaring away patients. Both antidepressants and benzos are among the top ten dispensed prescriptions in the United States, according to IMS Health, which tracks pharmaceutical data. More people are using them every year. The number of prescriptions filled for antidepressants (SSRIs and SNRIs) grew by 17 percent between 2005 and 2009. Benzo prescriptions rose by 15 percent during the same period.
Psychiatrists caution that all of these medications should be coupled with counseling. “Pyschotherapy has become unfashionable,” laments noted psychiatrist Alvin Rosenfeld—not to mention expensive and time-consuming. Some worry that it’s easier to borrow a line from the Stones: “Doctor, please, some more of these.”
This article first appeared in the December 2010 issue of The Washingtonian.