Anxiety

Anxiety can manifest in different forms, such as generalised anxiety disorder, panic disorder, social anxiety disorder, and specific phobias. 

Anxiety disorders are characterised by intense, prolonged worry and fear about everyday situations.

The causes of anxiety are multifactorial, involving:

• Genetics
• Brain chemistry
• Personality
• Life experiences, particularly traumatic ones
• Environmental factors such as stress from work or relationships

Common symptoms of anxiety disorders include:

• Feeling nervous or tense
• Increased heart rate
• Hyperventilation (rapid breathing)
• Sweating
• Trembling
• Feeling weak or fatigued
• Trouble concentrating
• Insomnia
• Avoidance of situations that may trigger anxiety

In Australia and around the world:

• Benzodiazepines: Diazepam (Valium), Alprazolam (Xanax)
• Selective Serotonin Reuptake Inhibitors (SSRIs): Sertraline (Zoloft), Escitalopram (Lexapro)
• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Venlafaxine (Effexor), Duloxetine (Cymbalta)
• Buspirone: An anti-anxiety medication, specifically for chronic anxiety

• Benzodiazepines: Drowsiness, confusion, addiction potential
• SSRIs: Nausea, weight gain, sexual dysfunction, insomnia
• SNRIs: Dry mouth, dizziness, excessive sweating, loss of appetite
• Buspirone: Dizziness, nausea, headache, nervousness

An estimated 284 million people worldwide have anxiety disorders. 

In Australia, anxiety disorders affect around 14% of the adult population, or approximately 2.3 million people.

• Cognitive-Behavioral Therapy (CBT): A well-researched approach to reducing anxiety symptoms.
  • Reference: Hofmann SG, et al. The efficacy of cognitive-behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research. 2012.
• Mindfulness and Meditation: Practices to cultivate presence and awareness can reduce anxiety.
  • Reference: Chittaranjan A, et al. Mindfulness-based stress reduction for anxiety disorders: A systematic review and meta-analysis. Journal of Psychiatric Research. 2020.
• Exercise: Regular physical activity can have a calming effect on the mind.
  • Reference: Stonerock GL, et al. Exercise as treatment for anxiety: Systematic review and analysis. Annals of Behavioral Medicine. 2015.
• Herbal Remedies: Some studies suggest herbs like kava and lavender may be effective, but caution is advised, and consultation with a healthcare provider is essential.
  • Reference: Sarris J, et al. Plant-based medicines for anxiety disorders, part 1: a review of preclinical studies. CNS Drugs. 2013.

De-prescribing for anxiety often focuses on reducing dependence on medications, particularly benzodiazepines, while enhancing coping strategies.

• Benzodiazepine Withdrawal Programs: Gradual tapering under professional guidance, often in combination with CBT, can be successful.
  • Reference: Voshaar RC, et al. Strategies for discontinuing long-term benzodiazepine use. The British Journal of Psychiatry. 2006. Link
• Integrative Medicine Approaches: Holistic approaches that include therapy, lifestyle changes, and mindfulness can support medication reduction.
  • Reference: Sarris J, et al. Integrative mental healthcare: Multidisciplinary, multimodal, and individualized treatment for mental health conditions. Advances in Integrative Medicine. 2014. Link

Managing de-prescribing of anxiety disorders require a comprehensive approach, considering both pharmacological and non-pharmacological treatments. Collaboration with healthcare providers specializing in anxiety disorders and a focus on patient-centered care are vital for successful treatment and recovery.