Dear Dr. Roach: My mother has been on anxiety medication for one year. Her anxiety level continues to increase to the extent that she is unable to rest. She currently takes 30 mg buspirone daily for anxiety. She is also on 20 mg losartan. She is in otherwise good health. Is there any additional or different medication that you would recommend for her to improve the quality of her life? — D.F.
Answer: Anxiety is a condition nearly everybody has to deal with on a frequent basis. The difference in anxiety disorders is that the anxiety is difficult to control, happens more days than not and, most importantly, causes significant distress and impairment. Regular anxiety does not require medication treatment; anxiety disorders often do.
Before discussing alternative medication, I should mention that therapy, especially cognitive behavioral therapy, has been shown to be as effective as medication in treatment of generalized anxiety disorder. Unfortunately, there aren’t enough CBT practitioners in most areas of the country, and the COVID-19 pandemic has made in-person therapy challenging. Video therapy is an option for some people. Others prefer medication treatment.
Although buspirone is an effective treatment and relatively free of side effects, the most effective class of medication for generalized anxiety disorder in long-term use is the selective serotonin uptake inhibitor class. There are many SSRIs, and some of them are more calming than others. Any of them may be effective for a given person. Your mother could ask about alternate therapy and request a referral to a mental health professional who can provide it.
