Anxiety Medications Used for Bipolar Disorder

Research has found that anxiety is common in people with bipolar disorder, with more than half experiencing one or more anxiety disorders. Other people may not have enough anxiety symptoms to be formally diagnosed with an anxiety disorder but still need medication to manage symptoms.

For example, anxiety, worry, agitation, and insomnia are often experienced during bipolar depression and mixed episodes. Anxiety symptoms such as restlessness, worry, and irritability may occur during mania and hypomania. Thus, it's common for bipolar people to have anti-anxiety medications prescribed.

Anxiety medications, also called anti-anxiety medications or anxiolytics, are prescribed for anxiety disorders and for people with anxiety along with bipolar disorder or major depression. Anxiety medications help to make people less anxious and also help to ease restlessness and worry. Many of these medications also help people to sleep better.

Let's look at the different categories of medications used to treat anxiety and how they may be used for people with bipolar disorder.

Benzodiazepines

Benzodiazepines are one type of bipolar anxiety medication that might be prescribed. Many of these anxiety medications are also utilized for other conditions as well such as:

• Agitation
• Insomnia
• Chemotherapy-induced nausea and vomiting
• Alcohol withdrawal
• Seizures

Some of these medications are used primarily for their sedative effects, either to help with insomnia or as relaxation medications before surgery.

Benzodiazepine medications include:

• Valium (diazepam)
• Ativan (lorazepam)
• Klonopin (clonazepam)
• Serax (oxazepam)
• Librium (chlordiazepoxide)
• Xanax (alprazolam)
• Halcion (triazolam)
• Restoril (temazepam)

Antidepressants

Many antidepressant medications have been found to have a beneficial effect on anxiety, and unlike benzodiazepines, do not carry the same types of risks for dependence, abuse, and overdose. For this reason, these drugs are often the mainstay of treatment of anxiety of any form.

Drugs from different classes of antidepressants are commonly used, including:

Selective Serotonin Reuptake Inhibitors (SSRIs)

Some of the drugs in this category are mentioned below along with some of the indications. All of these may be considered for treatment of anxiety depending on your particular symptoms.

• Paxil (paroxetine): Paxil has many uses, including major depressive disorder, obsessive-compulsive disorder (OCD), panic disorder with or without agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD).
• Zoloft (sertraline): Zoloft is approved for the treatment of a number of disorders including major depressive disorder, OCD, panic disorder, premenstrual dysphoric disorder, and social anxiety disorder.
• Prozac (fluoxetine): Prozac is approved for treating depression, OCD, and panic disorder.
• Luvox (fluvoxamine): Luvox is commonly used to treat obsessive-compulsive disorder (OCD).

Selective Norepinephrine Reuptake Inhibitors (SNRIs)

Drugs that inhibit the reuptake of both the neurotransmitters serotonin and norepinephrine may also be used to treat anxiety. SNRIs include:

• Cymbalta (duloxetine)
• Effexor (venlafaxine)
• Pristiq (desvenlafaxine)

Tricyclic Antidepressants

The older tricyclic antidepressants are used less often for treating anxiety with bipolar disorder but may be helpful in certain circumstances.

Buspar (Buspirone)

Buspar (buspirone) is unrelated to the medications above but may be helpful for anxiety with bipolar disorder, especially when combined with an antidepressant. Buspirone may be prescribed alongside mood stabilizers to help manage symptoms of anxiety associated with bipolar disorder.

The brand name BuSpar was discontinued, but the medication is still available in its generic form known as buspirone HCL.

While this medication generally has few side effects, there are some reports of mania on this drug, especially when combined with other medications.

Non-Medicinal Therapies

There are several other ways to approach the treatment of anxiety in addition to medications, and, in fact, a combination of treatments is most often the best approach. Other treatments may include:

• Psychotherapy, such as cognitive-behavioral therapy (CBT); CBT is considered one of the most effective treatments for anxiety
• Coping and relaxation techniques, such as deep breathing, progressive muscle relaxation, and meditation

Keep in mind that all anxiety is not bad. Some anxiety, or "eustress" ("good stress"), can help motivate people to perform better. However, excessive anxiety that leads to distress and disrupts your ability to function should be discussed with your doctor.