Can Anti-Anxiety Medications Worsen Depression Symptoms?

How Anti-Anxiety Medications Work

Typically, two medications are used to treat anxiety. The first is called serotonin and norepinephrine reuptake inhibitors (SNRIs). These include brand names, such as Cymbalta and Effexor. These medications are used for depression and mood disorders and are also prescribed for other medical conditions like fibromyalgia and neuropathic pain. They’re called reuptake inhibitors because they work in the body by increasing levels of serotonin and norepinephrine, which help stabilize mood. 

These should not be confused with selective serotonin reuptake inhibitors (SSRIs), which work by blocking the absorption of serotonin and stabilizing mood. Examples of SSRI medications include Lexapro, Prozac, and Zoloft. 

The second example of anti-anxiety medication is benzodiazepines. These drugs used to be the most prescribed drug in the world, but they quickly became one of the most abused as well. Benzodiazepines vary in potency and class and are used to treat various symptoms beyond anxiety. In fact, despite their potential for abuse, benzos are among the most widely used drugs to treat patients during alcohol detox, particularly to combat seizures. Among the different benzos, the single most prescribed one is Xanax, which is used most commonly for anxiety and panic disorders. The drug decreases abnormal excitement in the brain, suppressing the central nervous system, and producing a calming sensation. 

When Symptoms Worsen

Since many factors (age, weight, mental state) determine what drug is right for some people and not others, a doctor will prescribe these drugs with a specific dosage amount for each patient. They will also advise patients on warnings for using these drugs outside the prescription label’s directions. However, this does not guarantee they can avoid negative side effects altogether. Benzodiazepines are notorious for their black box warning, which the U.S. Food and Drug Administration (FDA) assigns to alert consumers that the drug has a very high potential for abuse, even when taken as prescribed. 

This means that using benzos, such as Xanax, for anxiety can result in building up a tolerance and eventually a dependency on the drug. The stronger the dependency, the more likely it is that depression symptoms will show up when the drug is not active in the body. It also makes quitting benzos difficult since depression is one of the drug’s withdrawal symptoms. 

Another concern is that when people become dependent on benzos, they might be tempted to take more than the prescribed amount to get the same relief from anxiety, or they might look for more ways to buy the drug beyond their legal prescription. Entering the illicit drug market is never a safe option since many people sell counterfeit benzo pills with deadly levels of filler drugs, such as fentanyl. Even if the results aren’t deadly, this carries a high risk of developing an addiction to multiple types of drugs, and the withdrawal symptoms can result in severe depression.

These concerns cause many people to assume that non-benzo options are safer. In general, these drugs carry a lesser risk of dependence, but they do not guarantee freedom from negative side effects. In fact, these drugs still carry a risk of worsening depression symptoms when taken as prescribed, including suicidal thoughts. Contributing factors, such as other drugs or alcohol use, can greatly intensify these negative side effects even more. 

Promoting Mental Health

Anti-anxiety medications can help people who struggle with anxiety and depression symptoms. But they carry a risk that we all need to take the time to learn about. Knowing this not only helps us make informed decisions about what kind of lifestyle we build for our mental health and what role medication plays, but it also helps us understand friends and family members who take these medications. This information puts us in a better position to help anyone who has depression as a result of taking these drugs, and we can help point them in the right direction for professional help if needed.