Medicines for anxiety
People experience anxiety in different ways. You might have feelings of fear, dread, unease or even tight muscles. Some of these symptoms can contribute to your physical pain during breast cancer treatment.
If you are concerned about anxiety, talk with your healthcare team. One option to treat these symptoms is medicine. It is OK, and very common, to take medicine while you are learning new coping skills.
Doctors use many different medicines to manage anxiety that results from cancer or its treatment. These medicines work differently, and all can cause side effects. These sometimes lessen over time. If you don’t like the way a medicine makes you feel, talk with your doctor.
Choosing a medicine depends on many factors, including other medicines you take and your unique needs. Some can take several weeks to start working, so don’t give up! Continue taking them as prescribed, even if you don’t feel better right away.
Here are some medicines available if you are feeling anxious because of a breast cancer diagnosis or treatment:
Selective serotonin reuptake inhibitors, or SSRIs, are the standard therapy to treat anxiety and depression together. They include
- citalopram (Celexa)
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- paroxetine (Paxil)
- sertraline (Zoloft)
Serotonin and norepinephrine reuptake inhibitor, or SNRIs, may also be used to treat anxiety and pain. These medicines include
- desvenlafaxine (Pristiq)
- duloxetine (Cymbalta)
- imipramine (Tofranil)
- venlafaxine (Effexor)
Other antidepressants that may be used to treat anxiety after a breast cancer diagnosis are
- bupropion (Wellbutrin), a norepinephrine and dopamine reuptake inhibitor (NDRI)
- mirtazapine (Remeron), a tetracyclic antidepressant
If your doctor prescribes an antidepressant to treat anxiety, you’ll probably start taking a low dose that will be increased over time. Antidepressants usually take 3 to 6 weeks to start working.
For more information on these medicines, how they work, how they interact with anticancer medicines and possible side effects, go to our section on antidepressants.
Benzodiazepines are medicines often prescribed to help with nausea caused by chemotherapy treatment. They may also be used if you have anxiety from time to time or mild, ongoing anxiety. Benzodiazepines affect areas in the central nervous system that control anxiety and sleep.
The benzodiazepines include
Benzodiazepines start working right away. If you take them for a long time, though, your doctor might need to increase the dose for these medicines to have the same effect. These medicines can lead to dependence, so doctors usually prescribe them for short periods.
When taking benzodiazepines, you should not drink alcohol. If you are an older adult, these medicines can increase your risk for falling and affect your cognition. With all anti-anxiety medicines, you should talk to your doctor before stopping, but it’s especially important with benzodiazepines. Stopping suddenly can have a serious effect. Your doctor will help you taper off when you are ready.
Buspirone (Buspar), an anti-anxiety medicine that works on serotonin and dopamine receptors in the brain, can also help relieve symptoms of anxiety. Unlike benzodiazepines, these medicines take 5 to 10 days to start working.
Like all medications, anti-anxiety medicines have side effects. They vary by the type of medicine and by person. When deciding whether to take medicine for anxiety, the risks of taking the medicine should be weighed against its benefits. You and your doctor will make this decision together.
Talk with your oncologist before starting medicines that aren’t part of your regular cancer treatment. As with your breast cancer treatments, report any side effects from your medicines. Sometimes one medicine doesn’t work right for you, and your doctor can suggest another.
Always consult your providers before stopping any medicine for anxiety. Stopping quickly without lowering the dosage could be dangerous.
For more information on specific types and possible side effects of medicines, visit the National Institute of Mental Health website.