What is the Process of Getting Anxiety Medication?
Introduction
Anxiety disorders, like generalized anxiety disorder, panic disorder, social anxiety, or phobias, are the most prevalent psychiatric disorders and are often unrecognized and untreated in primary care. (1)
For individuals suffering from anxiety, the prospect of obtaining anxiety medication can be daunting and overwhelming. Understanding the process and knowing the necessary steps to acquire medication for anxiety can help prevent people from going untreated.
Anxiety disorders can be treated with psychological therapy, medication, or a combination of both. This kind of treatment can significantly relieve individuals experiencing debilitating anxiety symptoms.
Obtaining anxiety medication requires a prescription, regular follow-up, and guidance from a health professional, necessitating in-person evaluation for prescriptions.
This article aims to guide individuals through the difference between psychotherapy and psychopharmacological treatments. It gives insight and information on accessing anti-anxiety drugs safely and effectively.
Additionally, it reviews some of the over-the-counter alternatives and lifestyle changes that could be helpful for people with anxiety disorders. It is worth noting, however, that you should consult a healthcare professional to find the best approach for you.
How Do You Know If You Really Need Anxiety Medication?
Anxiety medication requires a prescription from a licensed healthcare professional; some medications can be prescribed through telehealth. However, some medications can only be prescribed in person, such as benzodiazepines. (2, 3)
To determine an individualized approach, talk to your doctor or provider about your concerns, symptoms, and how they affect your life. Provide details about your concern about social situations, events triggering your symptoms, and any mental health treatments your biological relatives may have had. Your provider can determine the appropriate treatment based on your symptoms and various factors such as biological sex and weight.
Who Can Prescribe Anxiety Medication?
Anxiety medication can be prescribed by various healthcare professionals, including primary care physicians, psychiatrists, and nurse practitioners. In some states, specialized psychologists with additional training and certification may also prescribe medications. OBGYNs can address anxiety related to pregnancy or premenstrual dysphoric disorder.
Primary care physicians can prescribe mild anxiety medication, while psychiatrists can prescribe other medications and therapy. OBGYNs can prescribe anxiety medication for pregnancy-related anxiety disorders or premenstrual dysphoric disorder.
Psychologists typically provide talk therapy and psychological assessments. Still, some states, such as Iowa, Illinois, Idaho, New Mexico, and Louisiana, allow specialized psychiatry-trained psychologists to prescribe medications. (4)
By discussing your concerns and obtaining a prescription from a qualified healthcare provider, you can better understand the appropriate treatment for your condition.
How Do I Refill My Anxiety Medication?
Telehealth allows patients to connect with their healthcare providers virtually, offering secure HIPAA-compliant platforms for medication visits. However, online providers cannot prescribe all medications, and some medications require in-person evaluations. (3)
Providers may ask for follow-up appointments to assess the patient’s progress following a first medication appointment. If the patient feels better, they may provide a refill and schedule a follow-up appointment.
Attending follow-up appointments is crucial for timely refills and monitoring of the desired effects, as well as side effects. If unable to attend, it is best to contact the provider to request a refill before the medication runs out. Cold-stopping certain medications, like benzodiazepines, can cause withdrawal symptoms, which can be uncomfortable and potentially dangerous. (5)
Anxiety Medication
References: (6, 7)
Some anxiety medications may be prescribed according to the labeling information, meaning it is FDA approved to treat a specific condition. On the contrary, off-label prescription means the medication is FDA approved, but for another condition than that the health professional prescribes it.
When treating anxiety symptoms, doctors can prescribe medication according to the requirements of the patient’s condition.
On-label Medication
Benzodiazepines may be prescribed for short-term relief of acute anxiety symptoms in generalized anxiety disorder, panic disorder, and social anxiety disorder, typically after first-line treatments like SSRIs or CBT have been considered due to concerns over dependency and withdrawal. Some examples are, Valium (diazepam), Xanax (alzopram), Ativan (lorazepam), and Klonopin (clonazepam).
Buspirone: Can be prescribed for chronic anxiety and generalized anxiety disorders. It takes one to two weeks to take effect; therefore, it is not used to treat acute anxiety attacks. An example is BuSpar (buspirone). (2)
Selective Serotonin Reuptake Inhibitors (SSRIs): This group of medications are considered antidepressants but are also used as first-line treatments for anxiety disorders. Some examples are Zoloft (sertraline), Prozac (fluoxetine), and Lexapro (escitalopram).
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): These are antidepressants similar to SSRIs. Some examples are Effexor (venlafaxine), Pristiq (desvenlafaxine), and Cymbalta (duloxetine).
Tricyclic Antidepressants: These antidepressants are used for the treatment of anxiety. Some examples are Elavil (amitriptyline), Anafranil (clomipramine), and Tofranil (imipramine).
Off-label Medication
Beta-Blockers: They may be prescribed for a short term to manage symptoms related to anxiety disorders by blocking the effects of epinephrine, like trembling, sweating, or feeling your heartbeats (palpitations). Some examples are Inderal LA (propranolol), Tenormin (atenolol), and Secretal (acebutolol).
Anxiety Medication Alternatives (Supplements)
Reference: (7)
Besides anxiety medication, several alternative natural ingredients can help reduce anxiety levels and be bought over the counter. Although none of this guarantees an immediate cure, they can help reduce anxiety symptoms.
Despite its beneficial effects, long-term effects are not well known. Some supplements may interact with other medications; this is why before taking these alternative strategies, you should talk to your doctor to avoid undesirable effects.
Kava: This is a herbal supplement that is effective in managing anxiety. This alternative medicine should be used under supervision because it can interact with other medications and alcohol.
Passionflower and valerian: They have been shown to be beneficial in reducing anxiety and improving sleep quality, although it is less effective than kava. We should remember that high valerian root doses can worsen anxiety symptoms, like palpitations, headaches, and nausea.
5-HTP, L-Tryptophan, or Sam-e: These substances act on the brain and have been shown to increase serotonin levels and decrease anxiety symptoms. Although, there is no clear evidence of the extent of these results in patients with anxiety disorders.
Water and Magnesium: In some cases, anxiety can be caused by an imbalance or lack of important nutrients. This is why drinking sufficient water and taking magnesium supplements can help some people to reduce anxiety symptoms. However, it should not be used as a treatment for anxiety. You should always seek treatment with a health professional.
Ashwagandha: This extract is used in pills and helps reduce anxiety and stress in the short term. However, more studies are needed to understand its effects on anxiety in the long term.
L-Theanine: This is an amino acid sold over the counter in supplement form. A dosage of 200 milligrams per day of L-theanine in healthy adults reduces stress and anxiety and improves sleep quality.
Therapy vs. Medication
Reference: (8)
When considering psychotherapy and anti-anxiety medication, first, one has to be honest about their symptoms and consider whether these are disabling for daily life activities. In that case, anxiety medication can be a good resource for immediate relief.
However, many anxiety medications that treat these symptoms have side effects and considerable safety concerns. In addition, medication only helps with the consequences of anxiety. Still, it’s not a cure and may be difficult to get off without withdrawals, like rebound anxiety.
Therefore, although medication can help relieve anxiety and is a great tool for getting a fast result, it is more effective when used along with therapy, where a health professional can help treat the triggers of the anxiety. The most used technique is cognitive behavior therapy, considered a first-line treatment for generalized anxiety disorders, phobias, panic disorders, and others. (9)
Other types of therapy are:
- Exposure therapy.
- Dialectical behavior therapy.
- Acceptance and commitment therapy.
- Interpersonal therapy.
To conclude, anxiety medication can help with symptoms, but it is not for everyone and is not the only answer when dealing with anxiety. If you have severe anxiety, medication can be helpful in combination with therapy and exercise.
Lifestyle Changes
When taking anti-anxiety medication, it is also helpful to modify some lifestyle that will help to reduce the anxiety.
Having a Hobby: Spending time doing things you enjoy and taking time for yourself doing what you love helps reduce anxiety and also improves your quality of life.
Mindfulness: Meditating, journaling, or exploring spirituality may help reduce anxiety and fearful thoughts. (10, 11)
Exercising: Physical activity can help reduce anxiety by increasing the production of endorphins, dopamine, and serotonin. Some examples are dancing, going to the gym, walking, running, or biking.
Doing some activity: Keeping your mind occupied helps you stay present and take your mind off negative thoughts.
Cleaning: Keeping your working space and home tied up helps reduce anxiety levels. (12)
Frequently Asked Questions
Can I buy anxiety medication over the counter?
Anxiety medication can not be bought over the counter because it requires continued monitoring of desired or adverse effects. They influence the central nervous system and are used to treat anxiety symptoms but not cure them. Therefore, a health professional should always supervise their use. (13)
Why won’t my doctor prescribe me anxiety medication?
There are a couple of reasons why a doctor may not prescribe anxiety medication at first. On the one hand, therapy and lifestyle changes can be suggested as an initial approach. On the other hand, medications might not present a favorable side effect profile for the patient.
How to ask your doctor for anxiety medication?
To ask your doctor for anxiety medication, you should write down and then read to your doctor in the consultation:
- Symptoms that you have and when they began;
- Any major triggers of your symptoms;
- Any traumatic experience, both past and present;
- All your health conditions, both mental and physical;
- A list of all medications and supplements you’re taking.
Will your insurance cover the cost of your medication?
Insurance coverage for the treatment of anxiety disorders generally includes medications approved for such conditions. However, coverage for off-label use of medication may vary depending on the insurance policy and the specific medication’s evidence for effectiveness in treating anxiety. Therefore, the drugs prescribed according to the package label should be covered by insurance. However, you should always check with your provider before beginning the anxiety disorder treatment.
Conclusion
In summary, obtaining anxiety medication requires a prescription from a health professional, and sometimes, the process can be facilitated through telehealth appointments. However, some anxiety medications, like benzodiazepines, necessitate in-person evaluation due to their controlled status.
When deciding between psychotherapy and pharmacotherapy, it’s essential to consider the severity of the symptoms and their impact on daily life activities.
While medication can provide instant relief, it can reduce the symptoms but not cure anxiety disorders. Therefore, it is always beneficial to combine anxiety medication with therapy to reach the root of the problem and be able to address the triggers and underlying causes of anxiety.
See Also
What is the Prescription Filling Process Between Doctors & Pharmacies?
FDA-Approved Medications for Pediatric Anxiety
Can a Psychologist Prescribe Medication?
What is a Telehealth Psychiatrist?
Bupropion Interactions: What Drugs Shouldn’t be Used Together
What To Do If Lexapro Side Effects Occur?
How to Get Prescription Refill Without a Doctor?
Self Prescribing Laws in the US
- Craske, M., Stein, M., Eley, T. et al. Anxiety disorders. Nat Rev Dis Primers 3, 17024 (2017). https://doi.org/10.1038/nrdp.2017.24
- Drug Enforcement Administration. (2020). Benzodiazepines. Available from: https://www.dea.gov/sites/default/files/2020-06/Benzodiazepenes-2020_1.pdf
- Health Resources and Services Administration. (2021). Prescribing controlled substances via telehealth. Available from: https://telehealth.hhs.gov/providers/policy-changes-during-the-covid-19-public-health-emergency/prescribing-controlled-substances-via-telehealth/
- American Psychological Association. (2022). About prescribing psychologists. Available from: https://www.apaservices.org/practice/advocacy/authority/prescribing-psychologists
- National Institute of Mental Health. (2018). Anxiety disorders. Available from: https://www.nimh.nih.gov/health/topics/anxiety-disorders
- Melinda Smith, M.A., Lawrence Robinson and Jeanne Segal, Ph.D. Anxiety Medication. Last updated or reviewed on March 1, 2023. Available from: https://www.helpguide.org/articles/anxiety/anxiety-medication.htm
- Leonard Holmes, PhD. Anti-Anxiety Medication and Other Coping Strategies. Updated on May 05, 2023. Available from: https://www.verywellmind.com/anti-anxiety-medications-2330663
- Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017 Jun;19(2):93-107. doi: 10.31887/DCNS.2017.19.2/bbandelow. PMID: 28867934; PMCID: PMC5573566. Treatment of anxiety disorders – PubMed (nih.gov)
- Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkin Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence – PubMed (nih.gov)
- Breedvelt JJF, Amanvermez Y, Harrer M, et al. The effects of meditation, yoga, and mindfulness on depression, anxiety, and stress in tertiary education students: A meta-analysis. Front Psychiatry. 2019;10:193. doi:10.3389/fpsyt.2019.00193 The Effects of Meditation, Yoga, and Mindfulness on Depression, Anxiety, and Stress in Tertiary Education Students: A Meta-Analysis – PubMed (nih.gov)
- Rathakrishnan B, Singh SSB, Yahaya A, Kamaluddin MR, Aziz SFA. The relationship among spirituality, fear, and mental health on COVID-19 among adults: An exploratory research. Front Psychol. 2022;12:815332. doi:10.3389/fpsyg.2021.815332 Frontiers | The Relationship Among Spirituality, Fear, and Mental Health on COVID-19 Among Adults: An Exploratory Research (frontiersin.org)
- Aso Y, Yamaoka K, Nemoto A, Naganuma Y, Saito M. Effectiveness of a ‘Workshop on Decluttering and Organising’ programme for teens and middle-aged adults with difficulty decluttering: a study protocol of an open-label, randomised, parallel-group, superiority trial in Japan. BMJ Open. 2017;7(6):e014687. doi:10.1136/bmjopen-2016-014687 Effectiveness of a ‘Workshop on Decluttering and Organising’ programme for teens and middle-aged adults with difficulty decluttering: a study protocol of an open-label, randomised, parallel-group, superiority trial in Japan | BMJ Open
- Micah Abraham, BSc. Are There Any Over-The-Counter Anxiety Medications?. Last updated November 26, 2022. CalmClinic. Available from: https://www.calmclinic.com/anxiety/drugs/over-the-counter-medication
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