Long-Term Use of Anti-Anxiety Medications: Safety and Concerns

Regarding the use of the anti-anxiety medication Ease Tablets?

I consulted with the first psychiatrist who prescribed tricyclic antidepressants, specifically Amitriptyline.
After taking it for a month and a half, I stopped completely and experienced withdrawal symptoms that nearly drove me to despair, although I was also afraid of dying.
After the withdrawal symptoms subsided, I improved significantly, but I was left with tachycardia and severe insomnia.
After being referred by my family doctor, I was diagnosed in November 2014 with chronic agoraphobia, anxiety disorder, and chronic depression.
The doctor mentioned that my depression stemmed from my anxiety, describing it as mild depression.
Following the doctor's advice, I have been taking Escitalopram and Bisoprolol for nearly nine months, originally three times a day for each medication.
In mid-June 2015, my doctor reduced my dosage to one Escitalopram and one Bisoprolol in the morning and evening, and I have been on this regimen for a month now.
During the medication period, I have not experienced any discomfort or disease flare-ups, except for one unusual incident during my menstruation that lasted for about ten seconds, where I felt like I was about to have an episode but did not.
I am also undergoing psychotherapy.

I would like to ask if Escitalopram is a benzodiazepine and whether it is safe to take for such a long time without issues.
Will there be any tolerance or irreversible mental health conditions? Recently, there has been a serious illness in my family, and my doctor advised me to continue taking the same dosage without reducing or increasing it, as I was initially supposed to taper off the medication.
Do you think it would be okay for me to take it for twenty to thirty years? My doctor mentioned that my case is very mild.
I do not intend to rely on medication, but if my body does not cooperate, I am not opposed to continuing the medication.
I just want to confirm the safety of this type of medication.

nico, 30~39 year old female. Ask Date: 2015/07/20

Dr. Su Zongwei reply Psychiatry

Eisoo tablets are a mild benzodiazepine that generally have minimal side effects and are considered safe.
However, you should consult your physician.

Reply Date: 2015/07/20

More Info

When it comes to the long-term use of anti-anxiety medications, particularly benzodiazepines (like Alprazolam, commonly known as Xanax), there are several important considerations regarding safety, potential side effects, and alternative treatment options.

Understanding Benzodiazepines
Benzodiazepines are a class of medications commonly prescribed for anxiety and panic disorders. They work by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain, which has a calming effect. While these medications can be effective for short-term relief of anxiety symptoms, their long-term use raises concerns about dependence, tolerance, and withdrawal symptoms.

Long-Term Use and Dependence
1. Tolerance and Dependence: Over time, individuals may develop tolerance to benzodiazepines, meaning that they require higher doses to achieve the same therapeutic effect. This can lead to physical dependence, where the body adapts to the presence of the drug, and withdrawal symptoms may occur if the medication is suddenly stopped or reduced. Withdrawal symptoms can include anxiety, insomnia, irritability, and in severe cases, seizures.

2. Withdrawal Symptoms: As you mentioned, experiencing withdrawal symptoms can be distressing and may lead to a cycle of increased anxiety and reliance on the medication. It is crucial to taper off benzodiazepines under medical supervision to minimize withdrawal effects.

3. Cognitive Effects: Long-term use of benzodiazepines has been associated with cognitive impairment, including memory problems and difficulties with concentration. This is particularly concerning for older adults, who may be more susceptible to these effects.

Alternative Treatment Options
Given the potential risks associated with long-term benzodiazepine use, many healthcare providers recommend exploring alternative treatments for anxiety and panic disorders:
1. Selective Serotonin Reuptake Inhibitors (SSRIs): Medications such as fluoxetine (Prozac) or sertraline (Zoloft) are often prescribed for anxiety and depression. They generally have a better safety profile for long-term use compared to benzodiazepines and do not carry the same risk of dependence.

2. Cognitive Behavioral Therapy (CBT): This form of psychotherapy is highly effective for anxiety disorders. It helps individuals identify and change negative thought patterns and behaviors that contribute to anxiety.

3. Lifestyle Modifications: Regular exercise, a balanced diet, adequate sleep, and mindfulness practices (like meditation or yoga) can significantly reduce anxiety symptoms and improve overall mental health.

4. Other Medications: Depending on individual circumstances, other medications such as buspirone (Buspar) or certain antidepressants may be considered as alternatives to benzodiazepines.

Monitoring and Communication with Healthcare Providers
It is essential to maintain open communication with your healthcare provider regarding your treatment plan. Regular check-ins can help assess the effectiveness of your current medications and make necessary adjustments. If you have concerns about long-term use, discuss them with your doctor, who may suggest a gradual tapering plan or alternative therapies.

Conclusion
While benzodiazepines can provide significant relief for anxiety symptoms, their long-term use poses risks that should not be overlooked. It is crucial to weigh these risks against the benefits and to explore alternative treatment options that may offer a safer and more sustainable approach to managing anxiety. Always consult with your healthcare provider before making any changes to your medication regimen or treatment plan.

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