Anxiety disorders

Anxiety disorders are the most common mental disorders in the United States. Millions of people suffer from anxiety every year. Unfortunately, only about 36% of those suffering receive treatment (Facts & Statistics, n.d.). Treatments for anxiety are typically forms of therapy and medication. For many years, alprazolam has been the drug of choice prescribed by doctors to treat anxiety. Because we now have evidence that supports the addictive nature and harmful side effects of alprazolam, it is important to determine if a there is another drug that would be more effective. Recent studies have proven that a new drug, vortioxetine, can successfully treat anxiety with little side effects.

Although research has been done to determine the effectiveness of alprazolam and vortioxetine, we know little about the perceptions people have on these anti-anxiety medications. The purpose of this study is to find the perceptions people have of alprazolam and vortioxetine, along with all psychiatric medications in general. This study aims to find if people with anxiety disorders are more likely to have negative perceptions of anti-anxiety medications opposed to people who aren’t diagnosed with an anxiety disorder. College students are the target population being examined because a whopping 41.6% of college students suffer from an anxiety disorder (American Psychological Association, 2013). 41.6% of college students claimed that anxiety was their top concern and 24.5% reported to taking psychiatric medication to combat their anxiety (Anxiety and Depression Association of America, n.d.). Finding out the perception’s college students’ have of anxiety medication can be beneficial when trying to treat them. If a student has extremely negative perceptions about alprazolam, they may inaccurately apply those perceptions to all anxiety medications; therefore, they may not be receiving the help they need. Out of all the anti-anxiety medications, the perceptions of alprazolam and vortioxetine will be compared for this study because of their differences. Alprazolam has been out since the 1980’s, it is one of the most popular drugs to prescribe and misuse, it has serious side effects, and it is well known; on the other hand, vortioxetine just came out in 2013, it is effective in treating anxiety symptoms but it is not popular yet, the side effects aren’t severe, and it isn’t well known.

Literature Review

Alprazolam is one of the most commonly prescribed drugs used to treat anxiety disorders. Also known as Xanax, this medication has been around since the 1980’s. It is classified as a benzodiazepine because of the calming effect it has on the body. Alprazolam was originally intended to treat panic disorder, but after a few years of being released mental health professionals began to prescribe alprazolam for generalized anxiety disorder as well. An article titled Alprazolam, published by Brown University, explains important medical information relating to the drug. According to this article, alprazolam is intended to treat generalized anxiety disorder, short-term anxiety relief, anxiety associated with depression, and agoraphobia. Possible side effects include fatigue, dizziness, migraines, confusion, insomnia, nausea, indigestion, irritability, decreased libido, blurred vision, rashes, weight loss or gain, and cognitive impairment. It is common for depression to occur or worsen while taking alprazolam. A typical starting dose for adults with generalized anxiety disorder is 0.25 mg to 0.5 mg three times a day. To get off this drug, it is important to gradually lessen doses until an end is reached (Alprazolam, 2005).

Lydiard, Ballenger, Howell, & Laraia (1988) state that alprazolam is known for treating social phobia and anxiety. The authors performed an 8 week trial on 14 patients taking alprazolam. During the first two weeks of the trial anxiety symptoms began to improve and panic attacks decreased or went away after the trial was completed (Lydiard, Balenger, Howell, & Laraia (1988). Alprazolam seems to work in lessening anxiety symptoms; however, its addictive qualities make it a poor choice for some people. Individuals who have gone through addictions should stay clear of alprazolam. Some may become dependent on the calm, trace-like state it gives to the mind and body.

According to Ait-Daoud, Hamby, Sharma, & Blevins (2017), alprazolam is one of the most highly prescribed medications for the treatment of Generalized Anxiety Disorder and Panic Disorder. Although alprazolam is a popular anti-anxiety medication, it is commonly misused and known to be more dangerous when an overdose occurs. It’s clinical usefulness in treating anxiety is controversial among addiction specialists because they consider it to be a highly addictive drug. Unfortunately, many primary care physicians tend to prescribe it for longer than recommended (Ait-Daoud, Hamby, Sharma, & Blevins (2017). Alprazolam may help to decrease anxiety symptoms, but if it is creating new problems for an individual, such as addiction, it may not be the right choice.

The addictive nature of this drug makes it especially dangerous for individuals with addictive personalities. Because of the addictive qualities and the side effects, people being prescribed alprazolam should only take it as needed. Serious problems can arise when patients begin taking alprazolam for every little inconvenience they face. Klosko, Barlow, Tassinari, & Cerny (1990) claim that although alprazolam is a top choice when it comes to treating anxiety, there is a price to pay. The side effects that come along with this drug are sometimes enough for people to stay away entirely. Serious side effects include cognitive impairment, extreme fatigue, dizziness, depression, suicidal thoughts, memory loss, ataxia, trouble focusing, and more. Also, many people don’t like how alprazolam makes them feel; it is a calming agent, so instead of feeling anxious one feels more sedated. Not feeling anxious is the goal, but if the feeling (sedation) that is replacing the anxiety is unpleasant for someone, the drug isn’t benefitting them; therefore, people look for alternative options such as different medication or therapy (Klosko, Barlow, Tassinari, & Cerny, 1990).

According to a study by Brandt, Taverna, & Hallock (2014), Xanax is the most popular anti-anxiety drug of choice among college students. The authors conducted this study to find the patterns of use for various drugs done by college students. An online survey was sent to students and 303 completed it. Out of the sample, 36.8% of students admitted to using prescription drugs for non-medical reasons and 39.8% of reported users claimed to use some form of anti-anxiety medication. The majority of students taking anti-anxiety drugs chose to use Xanax opposed to other medications (Brandt, Taverna, & Hallock, 2014). This study exemplifies why Xanax could be viewed negatively; it is a popular drug to misuse and college students use it for non-medical reasons.

In 2013, the FDA approved a new drug called vortioxetine. Vortioxetine is an antidepressant; it works by helping the brain to restore serotonin. The primary use of this drug is to treat depression; however, recent evidence has proved that vortioxetine is also effective in treating anxiety. Currently, vortioxetine is widely prescribed to treat generalized anxiety disorder. A study done by Christensen, Loft, Florea, & Mcintyre (2017) examines the efficacy of vortioxetine in patients with Generalized Anxiety Disorder (GAD). Three hundred and one patients with GAD were randomly assigned to a vortioxetine group and a placebo group. The Hamilton Anxiety Rating Scale (HAM-A), Sheehan Disability Scale (SDS), and the Short Form-36 Health Survey were used to measure efficacy. Results found that vortioxetine was successful in treating GAD with little side effects. The most successful use of vortioxetine was in adults with GAD who were working and/or going to college opposed to the full GAD population (Christensen, Loft, Florea, & Mcintyre, 2017).

Baldwin, Florea, Jacobsen, Zhong, & Nomikos (2016) examined the use of vortioxetine in reducing anxiety symptoms for patients with major depressive disorder. Individuals suffering with MDD often have comorbid generalized anxiety disorder. Ten randomized trials were done over 6-8 week periods; in total, 1,497 subjects were given vortioxetine and 860 were given a placebo. The MADRS, HAM-A total, and HAM-A subscales were used to measure depression and anxiety symptoms before and after the trials. Results found that vortioxetine was efficacious in treating both depression and anxiety symptoms. Safety and tolerability were assessed by treatment-emergent adverse events (TEAEs). The most common TEAEs were nausea, headache, dizziness, dry mouth, diarrhea, nasopharyngitis, constipation, and vomiting; however, most participants on vortioxetine did not experience any of these (Baldwin, Florea, Jacobsen, Zhong, & Nomikos, 2016).