Medication Strategies For Stress Relief

Stress medications are varied, each addressing different aspects of stress symptoms. Commonly prescribed types include:

• • Benzodiazepines. Including Xanax and Valium, these are used for their calming effects to reduce anxiety.

• • Selective serotonin reuptake inhibitors (SSRIs). Antidepressants like Prozac and Lexapro can also alleviate stress symptoms by influencing serotonin levels in the brain.

• • Beta-blockers. Medications like propranolol and atenolol, typically used for heart conditions, can reduce physical symptoms associated with stress.

It is essential to consult with a healthcare professional for guidance in choosing the appropriate stress medication. The effectiveness and safety of these medications can vary based on individual health conditions.

Stress medication encompasses a range of pharmaceuticals specifically designed to alleviate physical and psychological symptoms associated with stress. These medications do not directly cure stress but rather help manage its symptoms, such as anxiety, tension, insomnia, and other related issues. The choice of medication depends on various factors, including individual symptoms, their severity, how they manifest in each person, and the response to previous treatments.

Given that stress is a result of the complex interactions between the body and brain, and various chemicals (neurotransmitters) are involved in this process, a broad spectrum of medications can be used to help manage and prevent stress. Physicians may prescribe a range of medications to address specific stress-related symptoms. For instance, sedatives, hypnotics, anxiolytics, antidepressants, and beta-blockers can all help people cope with stress.

As Dr. Brindusa Vanta, MD, notes, “Research indicates that approximately 60% to 80% of visits to family doctors may have a stress-related component.”

A note of caution is appropriate when using medicines for stress relief. Several medications that are beneficial for stress relief may pose addiction risks. It’s important to exercise caution to prevent potentially serious health issues associated with their use. All the medicines described below (addictive or not) have the potential for side effects and health risks and are only appropriate for use as prescribed by a licensed physician.

Understanding Stress and Its Health Implications

Stress is a natural response of the body to demands or challenges, playing a crucial role in our daily lives by driving motivation and alertness. This is also known as good stress. However, when stress becomes persistent or overwhelming, it can transition from being a normal, manageable aspect of life to bad stress—a condition that is harmful to physical and emotional health. Normal or good stress is typically temporary, arising from everyday situations like work deadlines or minor conflicts.

In contrast, stress that impairs daily functioning, such as that stemming from chronic life challenges or severe emotional distress, can lead to significant health issues. These may include mental health disorders like anxiety and depression or physical problems such as hypertension and a weakened immune system. Recognizing when stress levels are no longer beneficial and potentially harmful is essential in determining the need for medical intervention, which can range from counseling to medication.

When Is Medication Recommended for Stress?

Medication for stress is typically considered when non-pharmacological interventions like lifestyle changes and counseling are insufficient to manage symptoms effectively. Doctors may recommend prescription medications based on the following factors.

• Severity of symptoms: Medication may be appropriate if stress symptoms are severe enough to interfere significantly with daily life, such as causing persistent insomnia, crippling anxiety, or debilitating physical symptoms.
• Duration of stress: Chronic stress, persisting over an extended period despite other management strategies, might necessitate medication to prevent long-term health implications.
• Individual health history: A patient’s overall health, including any existing mental health conditions, physical health issues, and past responses to stress, is crucial in determining the appropriateness of medication.
• Response to other treatments: If traditional stress management techniques, such as therapy or relaxation techniques, haven’t provided adequate relief, medication might be considered to manage symptoms.

Healthcare providers base their decision to prescribe medication on a thorough evaluation of these factors, ensuring that it’s a suitable and necessary part of a comprehensive stress management plan. It’s important to note that people often use medication for stress in conjunction with psychotherapy and healthy lifestyle changes.

Types of Medication for Stress

Exploring the array of medications available for stress management reveals a diverse landscape of treatment options. Each medication type, from benzodiazepines and SSRIs to beta-blockers, targets specific symptoms and underlying mechanisms associated with stress. These medications address different aspects of stress, from calming effects to mood stabilization and physical symptom alleviation.

Sedative (CNS Depressant) Medications

Sedative medications depress (slow down or inhibit) the activity of the central nervous system (CNS), causing a sense of relaxation, reduced anxiety and tension, sleepiness, and slowed breathing. In higher doses, these medications can cause slurred speech, an impaired ability to walk around, poor judgment, and slowed reflexes. It is possible to overdose on such medications with potentially lethal effects (although some types of sedatives achieve lethal doses more easily than others).

One of the most commonly prescribed groups of sedatives is the benzodiazepines, which include alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), triazolam (Halcion), temazepam (Restoril), and chlordiazepoxide (Librium). As CNS depressant drugs go, benzodiazepines are relatively safe substances with a relatively low lethality potential. An older class of CNS depressant drugs, barbiturates are less safe to use (as a rule) than benzodiazepines. As a result, barbiturates are less commonly prescribed today. Alcohol (the active ingredient in liquor, beer, and wine) is also a sedative. Combining alcohol with other CNS depressants can enhance the effects of each and increase the risk of adverse reactions.

Benzodiazepines, barbiturates, and alcohol produce their calming effects by activating a naturally occurring neurotransmitter substance commonly found in the brain called GABA. GABA is an inhibitory neurotransmitter that slows down brain activity. By activating GABA, benzodiazepines, barbiturates, and alcohol all inhibit brain activity and calm down the body.

Other commonly prescribed drugs with sedating effects include antihistamines (medications typically used to decrease allergic reactions such as Atarax or Vistaril) and sleeping medications (e.g., glutethimide (Doriden), methyprylon (Noludar), and ethchlorvynol (Placidyl). Most sedative medications have the potential to cause physiological and psychological dependence (addiction) when taken regularly. Persons with substance use disorders may experience withdrawal symptoms, including potentially severe restlessness, insomnia, and even death if they do not continue to take their medication. Combining multiple sedatives (or taking sedatives together with alcohol) can lead to coma or death.

Buspirone (BuSpar)

BuSpar is an anti-anxiety medication that is not chemically related to benzodiazepines, barbiturates, or other sedative/anxiolytic drugs. BuSpar treats the physical symptoms of anxiety, such as bodily tension, dizziness, racing heartbeat, etc. This medication is a short-term remedy for anxiety (i.e., patients use it for no more than 4 weeks at a time). Therefore, it is not a good option as a long-term stress-reducing strategy.

BuSpar does not exert anti-convulsant (anti-seizure) or muscle-relaxing effects and is non-sedating. Although it’s not entirely clear how this drug works, some research suggests BuSpar influences mood by modulating the levels of neurotransmitters such as serotonin and dopamine. BuSpar is generally considered non-addictive. Individuals taking BuSpar don’t typically develop a tolerance, so they don’t require higher amounts of the medication over time to achieve the same therapeutic effects.

The main disadvantage of BuSpar is that it takes about 1-3 weeks before people experience relief from their anxiety symptoms. Also, many people report that BuSpar does not work as well as benzodiazepines for controlling their symptoms.

Serious, life-threatening side effects can occur if people take BuSpar within 14 days after using an MAO inhibitor (e.g., phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate), which is an older medication that is sometimes prescribed to treat depressive symptoms. Grapefruit and grapefruit juice may also interact with BuSpar and lead to potentially dangerous side effects.

Antidepressant Medications

Antidepressant medications derive their family name from their function. They treat major depression and related conditions. However, these medications also have anti-anxiety properties and, in many cases, can treat symptoms of stress. These days, a particular family of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which includes Paxil and Lexapro, are the most commonly prescribed antidepressant medications for this anti-anxiety, anti-stress purpose.

SSRIs work at the neuronal level of the brain. Neurons communicate using neurotransmitters. Serotonin is a key neurotransmitter involved in susceptibility to depression and anxiety.

In normal neuronal communication, a sending neuron releases serotonin into the synapse, stimulating the receiving neuron. However, the rapid reuptake of serotonin that occurs in depression and anxiety leads to insufficient levels of this neurotransmitter. SSRI drugs slow down the reuptake process, allowing serotonin to stay in the synapse longer. As a result, serotonin levels increase, helping to improve mood and alleviate anxiety.

SSRI medications are not addictive in the classical sense. Still, there are negative side effects associated with their use, such as nausea, dizziness, dry mouth, sleep disturbances, and a wide range of sexual arousal and climax problems. For more information about SSRI medications, please consult this article in our major depression topic center.

Beta Blockers

Beta blockers are medications that typically control high blood pressure and treat certain heart problems. For some people, these medications can decrease stress symptoms. Beta blockers such as Inderal (propranolol) and Tenormin (atenolol) block the stress hormones epinephrine and norepinephrine from binding to specific receptors in the arteries and the heart muscle. This action results in widened arteries, slowed heart rate, and decreased force of contraction. The most common negative side effects of beta blockers are cold hands and feet, tiredness, and sleep disturbance (i.e., nightmares). Less common side effects of beta blocker use include impotence, dizziness, wheezing, digestive tract problems, skin rashes, and dry eyes.

Nutritional Supplements

Various nutritional supplements, including kava, passion flower, valerian, 5-HTP; and the herbs skullcap (Scutellaria lateriflora), chamomile (Anthemis nobilis), hops (Humulus Lupulus), motherwort (Leonurus cardiaca), and oats (oat straw) (Avena sativa) are in common use as stress and anxiety remedies.

Though most of these substances occur naturally (e.g., are harvested from plants rather than created in a laboratory), this does not mean that these substances are harmless. In certain doses and certain combinations, such supplements can exacerbate medical conditions and/or interfere with the effectiveness of prescription medications. It is always advised to consult with a physician trained in complementary and alternative medicine before using any of these herbal or nutritional substances.

As Dr. Brindusa Vanta, MD, explains, “For example, people who take antidepressants should typically avoid taking 5-HTP due to the risk of serotonin syndrome. This condition can lead to dangerous symptoms, including agitation, confusion, fluctuating blood pressure and heart rate, and even coma.”

Consulting a Health Care Provider for Stress Medication

When considering medication as a part of stress management, consulting with a health care provider is a critical step. The process of obtaining a prescription involves several important stages to ensure safety and effectiveness.

1. The initial consultation and assessment: The first step is a comprehensive evaluation by a health care provider. This assessment includes discussing symptoms, medical history, and any current treatments or medications. 
2. Choosing the right medication: Based on the assessment, the health care provider will recommend a medication that best suits the individual’s needs, taking into account factors like potential side effects and interactions with other medications.
3. Monitoring and follow-up: After prescribing a medication, regular follow-up appointments are essential. These sessions allow the health care provider to monitor the effectiveness of the medication and make adjustments if necessary. It also provides an opportunity for patients to discuss any concerns or side effects they may be experiencing.
4. Ongoing management: Managing stress often requires a combination of medication and other treatment methods, such as psychotherapy or lifestyle changes. The health care provider will guide the integration of these various approaches for a holistic stress management plan.

Consulting a health care provider ensures the right prescription and continuous support and guidance in managing stress effectively and safely.

Comprehensive Approach to Stress Management

The journey to effectively manage stress often requires professional guidance, particularly when medication is involved. However, it’s equally important to consider a holistic approach to stress management. Alongside medication, lifestyle modifications, such as regular physical activity, balanced nutrition, sufficient sleep, and stress-reducing practices like meditation, can offer substantial benefits. Additionally, psychological therapies provide valuable support in developing coping strategies and addressing the underlying causes of stress.

Ultimately, managing stress effectively typically involves a combination of these methods. Seeking professional advice and being open to a variety of treatment options, including both medical and non-medical approaches, is the key to a well-rounded and successful stress management strategy.