If the psychological treatments above have not helped you or you would prefer not to try them, you will usually be offered medication.

Your GP can prescribe a variety of different types of medication to treat GAD. Some medication is designed to be taken on a short-term basis, while other medicines are prescribed for longer periods.

Depending on your symptoms, you may require medicine to treat your physical symptoms as well as your psychological ones.

If you are considering taking medication for GAD, your GP should discuss the different options with you in detail, including the different types of medication, length of treatment, side effects and possible interactions with other medicines before you start a course of treatment.

You should also have regular appointments with your doctor to assess your progress when you are taking medication for GAD. These will usually take place every two to four weeks for the first three months, then every three months after that.

Tell your GP if you think you may be experiencing side effects from your medication. They may be able to adjust your dose or prescribe an alternative medication.

The main medications you may be offered to treat GAD are described below.

In most cases, the first medication you will be offered will be a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). This type of medication works by increasing the level of a chemical called serotonin in your brain.

Examples of SSRIs you may be prescribed include:

• sertraline
• escitalopram
• paroxetine.
• SSRIs can be taken on a long-term basis but, as with all antidepressants, they can take several weeks to start working. You will usually be started on a low dose, which will gradually be increased as your body adjusts to the medicine.
• Common side effects of SSRIs include:
• feeling agitated
• feeling or being sick
• indigestion
• diarrhoea or constipation
• loss of appetite and weight loss
• dizziness
• blurred vision
• dry mouth
• excessive sweating
• headaches
• problems sleeping (insomnia) or drowsiness
• low sex drive
• difficulty achieving orgasm during sex or masturbation
• in men, difficulty obtaining or maintaining an erection (erectile dysfunction)

These side effects should improve over time, although some – such as sexual problems – can persist.

If your medication isn't helping after about two months of treatment, or if it's causing unpleasant side effects, your GP may prescribe an alternative SSRI.

When you and your GP decide it's appropriate for you to stop taking your medication, you'll normally have your dose slowly reduced over the course of a few weeks to reduce the risk of withdrawal effects. Never stop taking your medication unless your GP specifically advises you to.

If SSRIs don't help ease your anxiety, you may be prescribed a different type of antidepressant known as a serotonin and noradrenaline reuptake inhibitor (SNRI). This type of medicine increases the amount of serotonin and noradrenaline in your brain.

Examples of SNRIs you may be prescribed include:

• venlafaxine
• duloxetine
• Common side effects of SNRIs include:
• feeling sick
• headaches
• drowsiness
• dizziness
• dry mouth
• constipation
• insomnia
• sweating

SNRIs can also increase your blood pressure, so your blood pressure will be monitored regularly during treatment.

As with SSRIs, some of the side effects – such as feeling sick, an upset stomach, problems sleeping and feeling agitated or more anxious – are more common in the first one or two weeks of treatment, but these usually settle as your body adjusts to the medication.

If SSRIs and SNRIs aren't suitable for you, you may be offered pregabalin. This is a medication known as an anticonvulsant, which is used to treat conditions such as epilepsy. However, it's also been found to be beneficial in treating anxiety.

Side effects of pregabalin can include:

• drowsiness
• dizziness
• increased appetite and weight gain
• blurred vision
• headaches
• dry mouth
• vertigo

Pregabalin is less likely to cause nausea or a low sex drive than SSRIs or SNRIs.

Benzodiazepines are a type of sedative that may sometimes be used as a short-term treatment during a particularly severe period of anxiety, because they help ease the symptoms within 30 to 90 minutes of taking the medication.

If you're prescribed a benzodiazepine, it will usually be diazepam.

Although benzodiazepines are very effective in treating the symptoms of anxiety, they can't be used for long periods of time because they can become addictive if used for longer than four weeks. Benzodiazepines also start to lose their effectiveness after this time.

For these reasons, you won't usually be prescribed benzodiazepines for any longer than two to four weeks at a time.

Side effects of benzodiazepines can include:

• drowsiness
• difficulty concentrating
• headaches
• vertigo
• tremor (an uncontrollable shake or tremble in part of the body)
• low sex drive

As drowsiness is a particularly common side effect of benzodiazepines, your ability to drive or operate machinery may be affected by taking this medication. You should avoid these activities during treatment.

For professional, caring and confidential help, adviice, therapy or treatment for, or about, any of the above issues or topics, or similar, just contact Peter, preferably by e-mail, to arrange an appointment for your free initial consultation.

Or maybe instead read Peter's Website Welcome Letter, or go to the home page and view The Surrey Hypnotherapy Clinic's Generalised Anxiety Disorder (GAD) Video Girls and their Website Welcome Video.

Acknowledgements

http://www.nhsdirect.wales.nhs.uk/Encyclopaedia/a/article/anxiety/#Self-help