Celexa (citalopram)
Lexapro (escitalopram)
Paxil (paroxetine)
Prozac (fluoxetine)
Zoloft (sertraline)
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| They include:- |
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SSRI's are often used to treat: panic disorder,
GAD (generalized anxiety disorder) and OCD (obsessive compulsive disorder)
ii) Tricyclic Antidepressants (TCA's)
Thought to be less
habit-forming than the cyclics ( eg.
benzodiazepines). Largely replaced by SSRI's they are still used
for some problems such as panic disorder. Unlike benzodiazepines,
tricyclics usually require only a daily single dose. TCA's include:-
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Gamanil (lofepramine) Tofranil (imipramine)
Timaxel(metapramine)
One major disadvantage of the tricyclics is that they sometimes
produce cardiac effects such as dizziness and palpitations, the very symptoms
they are used to alleviate.
iii) Monoamine Oxidase Inhibitors (MAOI's)
eg. Nardil (phenelzine)
One of the oldest classes of antidepressants,
this is often used
when others have not been effective. Possibly effective in
relieving panic disorder and social phobia MAOI's can have very serious side
effects (sudden increase in blood pressure) and people taking them often have
to have a restrictive diet to protect from this.
3.
Azapirones
A newer treatment, there is only one medication available: Buspar
(buspirone)
Buspirone is a milder tranquilizer. It works by regulating levels
of Serotonin and Dopamine in the brain. Slower acting than the traditional
anti-anxiety drugs, this medication has the advantage of not being as sedating
or addictive as the older types of tranquilizer and having less withdrawal
effects.
4.
Beta
Blockers
Originally developed to treat heart problems by reducing stress on
the heart, this class of drugs work by blocking the
adrenaline (produced when anxious) from acting
on various
organs in the body. Common beta blockers prescribed are:- Inderal
(propranolol)
Tenormin (atenolol)
Zebeta (bisoprolol)
Note that these drugs don't stop anxiety or
adrenaline but stop
some of the effects of the adrenaline eg. a speeding heart.
It is important to realise that medication is not a cure for
anxiety problems. Taking prescription drugs doesn't deal with the underlying
cause of the problem and once the medication is stopped symptoms usually return
with a vengeance. Also, many medications produce side effects, which may be as
bad as or worse than the actual problem, and long-term usage can lead to
addiction and withdrawal problems. The same is also true when taking medications
for depression; they do not cure the underlying problem.
That said, medication does have a place in the treatment of
anxiety problems. In some cases, good practice involves taking medication,
short-term, to help alleviate symptoms alongside an appropriate therapy to help
deal with any problematic thoughts, feelings and behaviours that exist.
Please Note: sudden withdrawal from
certain medications can be
dangerous and under no circumstances, should
anybody stop taking prescribed medication without fully qualified medical
supervision.
Treating
the Wrong Thing?
Current ideas about what causes anxiety and
depression problems falls into three main areas: genetics, physical brain
problems and chemical imbalance.
Many treatments are based on these ideas. Yet
there is
plenty of evidence to show that they are wrong, they are not the
cause of these problems and looking for answers based on them cannot work.
Perhaps
It’s in Our Genes?
Many anxiety disorders and depression problems
can be seen to run in families, but it's too easy to see this as proof of
genetics being the cause of these problems.
A depressed or anxiety-riddled parent may treat their child in
such a way, and provide such a role model, that the child could develop
emotional problems entirely through learning and conditioning.
Once the human genome was mapped (the entire DNA sequence that
makes up humans) it was hoped to be able to identify and cure the genetic cause
of almost everything. But that didn't happen. Whilst ground has been made
identifying DNA mutations or variations that may be associated with a higher
risk for certain diseases, the actual situation is a great deal more complex.
The position of the genes in relation to others and interactions between them
may exert as great an influence as the genes themselves. It's the structure as
a whole, the system, not just its constituent parts that is important.
Anxiety and depression problems are the same, it is the whole
system that counts: our mind and body and the environment they are in. Indeed
there are numerous findings from gene research that suggest mental 'illnesses'
do not occur because of a single gene.
Genetic information passed from our parents
regarding
certain physical attributes (hair and eye
colour, general size
etc.) may be fixed but the same cannot be said about our
behaviour. Information that is passed between a parent and child
does not result in actual behaviours, but predispositions. Not fixed behaviours
but ways of behaving we are susceptible to develop given the right stimulation.
A parent cannot pass on fixed behaviours, for the environment the child is born
into is unknown. The knowledge we inherit has to flexible to enable us to adapt
and survive – reacting with extreme anxiety to unconditional love would not be
adaptive.
We all come predisposed to learn language, but
the main language we eventually learn to speak depends on where in the world we
are born. Racehorses are bred to be good runners but they still have to be
groomed and trained. Any genetic information that we receive from our parents
can only be put into practice if the appropriate environment exists. DNA is our
past not our future. In fact there is evidence to show that DNA (considered to
be fixed and unchangeable) can actually change.
Experiments by Barbara McClintock in the 1950's showed vast
changes in the DNA of plants occurring when they were stressed. A stressful
environment actually resulted in whole sequences of DNA moving from one place
to another, even inserting themselves into active genes. Not random behaviour,
there was a method to their shifting and it was triggered by outside
influences; changes in the environment such as extreme heat or drought that
threatened the survival of the plant.
Initially ignored by her peers, McClintock
received a Nobel Prize for her work, some thirty years later.
Genes were changing due to experience in plants.
Imagine
what may be happening within the complexity of humans. Intuitively
we would expect this to be the case. Life is about growing, learning and
evolving. Genes shape our reaction to experiences and our reaction to
experiences and learning must shape our genes. We need not be slaves to our
genes!
Maybe
It's Because Our Brain is Different?
PET (Positron Emission Tomography) brain scans
of some people with severe anxiety disorders show increased activity and size
in certain areas of the brain.
Often seen in people with obsessive compulsive disorder (brain
scans of people with OCD show increased energy use in the orbital cortex of the
brain, compared to those who don't have OCD) such evidence can lead to the
conclusion that brain abnormalities (differences in the size and/or function of
certain areas in the brain) may be responsible for these problems.
However, brain scans of violinists show the area of the brain
devoted to his or her left fingers (the right primary motor cortex) to be 2 or
3 times larger than that of non- violinists. Constant use of these fingers in
playing the violin have formed and embedded the associated pattern of neural
connections in that part of the brain making it more active and larger.
It makes much more sense that the areas of
increased size and activity in the brain are a result of continued behaviour,
not the cause of the behaviour.
Or the
Chemicals in Our Brain are Out of Balance?
Synapses, those connections between the neurons in our brain
(around 10,000 for each neuron) are tiny spaces that are occupied by chemical
messengers (called neurotransmitters) that carry information between neurons.
Serotonin and Dopamine are the two neurotransmitters regularly
mentioned with regard to anxiety and depression problems. And chemical
imbalance, usually referring to deficiencies in these two neurotransmitters, is
often proffered as a reason for these problems. Well, anxiety and depression
deplete the body of many resources including: vitamins, minerals, energy and,
without doubt, also neurotransmitters.
Surely, any chemical imbalance is the result of these problems not the
cause. Balancing chemicals in the brain through medication may alleviate some
symptoms to a degree, but it never touches the root cause.
Current beliefs about mental illness, genetics, chemical
imbalances, physical brain problems, and treatments based on these beliefs have
failed millions of people looking for an answer to these problems. For they
miss the real cause of the problem and never deal with it at all. They leave us
struggling with symptoms, fighting in the dark, trying to deal with something
when we don't even know what it is.
In viewing anxiety problems in terms of the
brain and body and that something has gone wrong which needs fixing, the bigger
picture is often overlooked.
To deal with these problems successfully we need
to understand the system as a whole – brain, mind, body, spirit and environment
all interacting ... our whole being.
