Anxiety Treatment Not Working? Questions to Ask Your Provider
Based on Hope Integrative Medicine, Anxiety Not Improving on Your Medication?
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What to check when anxiety treatment is not working, and the next options: another SSRI or SNRI, buspirone, hydroxyzine and CBT, and when appropriate pregabalin, a controlled medicine that needs caution with opioids or sedatives.
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In this guide
Questions to Ask
- Was my dose given enough time?
- Could sleep or caffeine play a role?
- Should my thyroid be checked?
Non-Habit-Forming Options
- Buspirone, taken daily
- Hydroxyzine, for occasional use
- Therapy such as CBT
Use With Extra Caution
- Pregabalin is a controlled medicine
- Benzodiazepines: not long term
- Risky with opioids or alcohol
What the guideline says
- When anxiety does not improve with the first treatment, there are next steps, and the next step is usually not a benzodiazepine.
- First check the basics: whether the dose was high enough for at least six to eight weeks, whether the medicine was taken daily, and whether sleep problems, caffeine, alcohol or thyroid problems are driving symptoms.
- Cognitive behavioral therapy is as effective as medication for many anxiety disorders.
- Medication options include another SSRI or an SNRI, buspirone as a non-habit-forming daily medicine, and hydroxyzine as a non-habit-forming option for occasional use.
- Pregabalin is a controlled medicine that needs extra caution, because combined with opioids, alcohol or other sedatives it can cause dangerous breathing problems.
- Benzodiazepines work quickly, but daily long-term use brings dependence, memory and balance problems and difficult discontinuation.
Source: Hope Integrative Medicine, Anxiety Not Improving on Your Medication?
Read the full article: Anxiety Not Improving on Your Medication? Next Steps Beyond the First SSRI →
This guide is general health information and does not replace advice from your own provider.
Frequently Asked Questions
They work quickly, but daily long-term use brings dependence, memory and balance problems, and difficult discontinuation.
Hydroxyzine is a non-habit-forming option for occasional use. Your provider can tell you whether it fits your plan.
If you are having thoughts of harming yourself, call or text 988 or call 911.