But just because one drug is used more than another means very little. When a doctor picks a drug they try to pick the one that will best address your needs. A person with terrible OCD might get Luvox (fluvoxamine) first but people with another problems would almost never be prescribed that. In general Lexapro and Zoloft are the most effective SSRI class antidepressants. Aside from Effexor all the drugs I listed, including Luvox, are SSRI’s. Celexa (citalopram) is the other SSRI but I do not recommend people take it.

Have you been to a doctor (ideally a psychiatrist) for a diagnosis? There are many types of anxiety disorders and knowing which one you have will allow more targeted treatment. Generalized anxiety disorder (GAD) might respond well to BuSpar (buspirone), a drug similar to antidepressants but it is not approved for treating depression but it can be very good for GAD. Yet panic disorder is not normally treated with BuSpar, certainly not with good success.

By the way panic disorder does not mean having a lot of panic attacks, often people do not understand that. Panic attacks can and typically do occur in all anxiety disorders.

It sounds like you are normally fine and only occasionally have a panic attack, if so them most doctors (and most patients) tend to prefer a benzodiazepine (benzo) like Xanax (alprazolam), Ativan (lorazepam), Klonopin/Rivotril (clonazepam), or Valium (diazepam). These medications work in 20-60 min and are often taken as needed for severe anxiety or for a panic attack. The advantage is that it does not require taking a pill everyday, just if you needed it and you don’t have to wait 4-6 weeks as an antidepressant kicks in. The only risk is that benzo’s can be abused but it is not common and people taking it as needed rarely have any problem. However if you have a history of substance abuse (primarily to alcohol, benzodiazepines, or barbiturates) then they are not really a good option.

I have panic disorder with agoraphobia and major depressive disorder.

I am 23 and in medical school for psychiatry and for the last 10+ years I have battled depression and anxiety. I tried exactly 43 medications, of all classes and subclasses except a MAOI (a rarely used type antidepressant with many very serious food and drug interactions). It was very hard for me because I am one of the few who gets more depressed on antidepressants, and have severe anxiety and I had various other symptoms depending on the drug. I doubt you will be anything like me plusI got worse because of chronic pain and a sleeping disorder.

To figure out the best treatment you need a specific diagnosis.

Generalized anxiety disorder:

People with anxiety and depression typically take an SSRI or SNRI. People with anxiety alone may start with BuSpar or a SSRI. If the anxiety is mild sometimes a drug like hydroxyzine, an antihistamine, is used as needed. Clinical studies typically show hydroxyzine to be no more effective than placebo, at best it might be slightly more effective. After SSRI’s, SNRI’s, and BuSpar the tricyclic antidepressants (TCA’s) are commonly used. Keep in mind that if medications don’t work doctors will do what they feel is best so if SSRI’s fail some doctors instantly do TCA’s.

If all antidepressants fail or only help a little or have severe consequences then atypical antipsychotics like Seroquel (quetiapine) or Geodon (ziprasidone) may be used. The use of these drugs in anxiety disorders is highly controversial because their efficacy is not well known and they can have some very serious side effects. Sometimes doctors use anticonvulsants like Neurontin (gabapentin), which has no real evidence of helping anxiety, or Lyrica (pregabalin), an enhanced version of Neurontin that is approved in Europe for GAD. And then if nothing works often monotherapy with benzodiazepines is used. That is a very basic over view, there are more options and anxiety is normally treated effectively without trying many medications.

Certain types of therapy could help, CBT is good for panic disorder, phobias, and OCD in particular. That really helped my agoraphobia. I also did more simplistic talk therapy which was only moderately helpful. I did support groups, learned meditation which did not help, I become very good at biofeedback but it did not really help, I reduced my school load for a while and that break was nice (this was in high school) and helped me collect myself, and I watched up beat movies. In the end, today, I do take medication for panic disorder with agoraphobia, depression, and a sleeping disorder. I was able to take much less thanks to CBT but I still take 4 mg of Xanax XR, a modest dose (the max is 10 mg/day) but I have been prescribed up to 12 mg/day, a vast dose. And now I have almost no s
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I am a medical student at a university in Montréal, QC, Canada for psychiatry and internal medicine. I have a Hons. BSc in pharmacology and I have interned with two psychiatrists and one neurologist. In addition, I have worked as a pharmacy assistant.

Personal experience.

hope this helps (:
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