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Well, since you asked...
There are two basic pharmacologcial treatments for a generalized kind of anxiety. These are selective serotonin reuptake inhibitors (SSRI) and benzodiazepines. Now the SSRIs work by increasing the amount of a specific kind of chemical messenger in your brain (serotonin, mostly). Increasing this chemical allows certain pathways of your brain to function easier or more efficently. This tends to elevate mood, improve focus and reduce perseveration (going over and over things in your mind or constantly focussing on one thing to the exclusion of all else). The SSRIs that have been tested and shown to have good results are paroxetine (Paxil) and sertraline (Zoloft). Fluoxetine (Prozac) is not so good for this particular use, but is an excellent drug for other situations. A drawback of these medications is that most people don't get the full effect for two weeks. Also, there can be some significant side effects, namely either fatigue or energy, loss of appetite, and an inability to orgasm.
Benzodiazpines work by enhancing the calming, slowing portions of your brain, the GABA system. The rush of thoughts is diminished, and the patient is able to approach situations more calmly and without a rush of anxiety. They are usually able to handle surprises better as well. The is really only one benzodiazepine recommended for long term treatment of major anxiety and that is alprazolam (Xanax). There is an extended release formulation that is supposed to give better control of your anxiety and lessen any euphoria from taking the medication. Sleepiness and fatigue are the common side effects here. As it is a benzodiazepine, dependance is a concern. Dependance is less likely with an extended release formulation than with a instant release. Also, given its long half-life and the general nature of benzos, stopping taking them usually involves little to no symptions of withdrawl when you taper the dose.
Now, this is just a nutshell amount of information. If we were to meet and do this professionally, I would take a good 20-30 minutes to go over all the options and their consequences. There are several other pharmacutical options, but the two mentioned above are the most common that I know of. When you see your physician, discuss options. Talk with your pharmacist about what to expect.
Medication is only a portion of the solution. It is a crutch. But, crutches are useful. When you break your leg it makes getting around much easier. At some point, however, the leg heals and you don't need the crutch anymore. This is similar. It can be difficult to say exactly how long medication may be needed for your case. This is something that requires discussion between you and the health care workers that you become involved with. Overcoming your anxiety will take more than just medication, and you and your physician can work out exactly what that means.
If you have any other questions please feel free to ask. I'll keep an eye on the thread.
Baron Opal, Pharm.D.
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