Ever wondered how your anxiety meds actually do what they do?
See, I think I may need to go back on medication. This is an agonizing decision for me because even though I know Prozac lifts the heavy weight that sits on my shoulders, it also comes with a slew of side effects that affect my quality of life in a different way. It is pretty much just trading one type of mental anguish for another.
I have been on (and off) several medications, Prozac being the most effective, but the side effects of each has led me to do a lot of research on the types of medication that are available to anxiety sufferers. This is what I have learned in my research:
First of all there are these little things floating around in your brain/body called neurotransmitters. And they, well…they transmit. They travel from receptor site to receptor site passing along information about what you’re feeling at that time. There are different ones and they all convey different bits of information. Anxiety deals with a few different neurotransmitters.
THE KEY PLAYERS (NEUROTRANSMITTERS)
Serotonin (my favorite, also the chemical compound shown in the upper corner of my blog): Key word here is HAPPINESS. Like when you have had a wonderful day at the beach.
Gamma-Aminobutyric Acid (or GABA, my second favorite): key words here are RELAXATION and CALM. Like when you take a warm bath.
Dopamine: key word here is REWARDS. Like when you get a pay raise!
Norpinephrine/Epinephrine: key word here is ADRENALINE. Like when the fire alarm goes off while you’re in the shower…
So I’m sure there are more, and those are super basic explanations but it helps to know them when understanding how the different meds work.
You have your SSRIs (Prozac, Zoloft, Celexa, Lexapro, Paxil, Luvox): Basically you have little nubs in your brain that suck up the neurotransmitters from another nub in your brain (I think the nubs are actually nerve cells but all the pictures make them look like nubs).
When they’re not working right the initial nerve cell sends neurotransmitters over to another nerve cell and then is like JUST KIDDING, and reabsorbs them. This causes a shortage of that neurotransmitter. So what SSRIs (Serotonin Re-uptake Inhibitors) do is they bind to where the Serotonin is coming out and block it from going back into the nerve cell that it came out of (they Inhibit the Re-uptake). SSRIs are like those spikes in parking lots that allow you to leave but won’t let you back up. This keeps enough serotonin floatin’ around in your brain and therefore helps decrease anxiety and depression. These work the best for OCD because Serotonin plays a big role in the Obsession and Compulsion process.
Then there are SNRIs (Cymbalta, Effexor): These are essentially the same thing but they block the reuptake of Norepinephrine instead of Serotonin. This is so interesting to me because a Serotonin issue might cause one person’s anxiety, while a Norepinephrine issue might cause another’s. Or some unlucky people might even have an issue with both. This is why certain medications work for some people and not others.
Next up are the Benzos (Benzodiazepines) (Xanax, Klonopin, Valium, Ativan): These are my favorites but they can be super dangerous. They make you feel great, almost instantly calm, but they are incredibly addictive if you’re not careful and have some of the most dangerous withdrawals. I know for some of us that is something to obsess over but those warnings are in place for the people who need them so don’t freak out, just be aware. These work by binding to the sites that are receiving the GABA neurotransmitter and boosting the function of GABA. The little GABAs latch on and open a channel into the nerve cell, said channel allows chloride ions to enter. Once they enter the cell they sort of numb the cell to keep the other neurotransmitters that make you all worked up at bay (essentially keeping you calm).
GABA: holds the door open “Hey Chloride Ion! Welcome to the party, Adrenaline is already here!”
Cloride Ion: “YAYYYY” hugs Adrenaline really tight and won’t let go
Adrenaline: can’t do its job
Buspirone: This one is in a class of its own. I recently started looking into it because it doesn’t seem to have the side effects that I was experiencing with Prozac. However, my doctor does not want to prescribe it because of the rare but permanent side effect of developing a movement disorder such as a twitch. This would be permanent even once going off the medication, which is very scary. However it supposedly works very well for Generalized Anxiety Disorder. Buspirone is something called a selective serotonin subtype 1A (5-HT1A) partial agonist. But that sounds super confusing so basically it increases the release of Serotonin and Dopamine but in a more controlled manner than say a FULL agonist drug (such as morphine) would. It is like when you only partially open the vents in your car because you’re kinda cold but its too hot with the air off…
Gabapentin (Neurontin): This has been the most recent one I have researched because my doctor just wrote me a prescription for it last week. I have chosen not to take it because of people online saying it caused weight gain. Since that is the biggest reason I’m not going back on Prozac I don’t think it’s the right choice for me. It does seem that it can be effective for people though which is weird because it is primarily an anticonvulsant (used to treat seizures). It seems that they’re not too sure why it can work on anxiety but oddly enough it doesn’t seem to work on the GABA receptors, despite the name.
So to reiterate:
SSRIs- Keep Serotonin from being reabsorbed by the nerve cells that release it
SSNIs- Keep Norepinephrine from being reabsorbed by the nerve cells that release it
Benzos- Help GABA to do its job of making you numb to stress
Buspirone: Increases Serotonin and Dopamine in a controlled way
Gabapentin: No one seems to know…
This is obviously not everything that can be prescribed for anxiety, but these are the ones I have looked in to.
Are any of you on other types of anxiety medications? Or does anyone wish you could find a simpler explanation of a medication you’re taking?