There are several different kinds of medications used to treat anxiety. SSRI and NSRI antidepressants are usually the first type of drug used. Buspirone (BuSpar®), an atypical antidepressant, is also used to treat anxiety. The benzodiazepine drugs can be added if another drug is needed. This type of drug is best used sparingly because it can increase depression and apathy.

Severe anxiety symptoms may require the addition of a mood stabilizer medication.

Benzodiazepines

Clonazepam (Klonopin®) This drug works more slowly, but the effect lasts longer. Usually given twice a day for anxiety. This one is less helpful for insomnia. Dosages should start at 0.25 mg twice daily, increasing by 0.25 every 3 days until best benefit. Dosage maximum is 4 mg in 24 hours.

Alprazolam (Xanax®) This drug works rapidly, but its effect is shorter, requiring dosage several times a day. This drug is less effective if depression is present with anxiety. Dosages should start at 0.5 in divided doses, increasing to 4 mg over 24 hours taken in intervals of 3 or 4 times per day.

Diazepam (Valium®) This drug can have a very long duration of action and often results in day time sleepiness. Usual dosages are 2 to 10 mg per day.

Lorazepam (Ativan®) This drug is rapidly absorbed and is often used for insomnia. It gives lesser daytime sleepiness than valium. If used for anxiety, daytime dosing is necessary. Dosing usually starts at 1 mg, but can be increased up to 6 mg or more in divided doses. Abrupt dscontinuation of high doses of this drug can cause seizures.