Does anxiety go away?

• Does anxiety go away or just become less severe? by Lyne Springer, M.Ed., 5/1/97
  
  

Lyne. In regards to medication and the treatment of anxiety disorders, the recommeded starting dose for Xanax is .50 mg. TID (three times a day). The "average" dose of Xanax given to patients with anxiety in the U.S. is 4.0 - 6.0 mg per day. If your friend's client is on only .50 mg of Xanax a day, this is probably not enough to control the symptoms of sympathetic nervous system arousal. Taking Xanx only one time a day can lead to interdose rebound phenomenon in which the patient will experience anxiety or panic caused by the medication dropping below a certain level in the bloodstream. That is why a patient needs to be on TID or QID dosing of Xanax. Klonopin is also quite useful and has a longer half-life than Xanax and as a result can be given in BID dosing and is less likely to cause interdose rebound phenomenon. Paxil is quite useful in the treatmet of anxiety disorders and is the only SSRI approved by the FDA for the treatment of Panic Disorder. With the right medication, the patient could then begin a program of in vivo desentization whereby he/she would "gradually" be exposed to more anxiety-provoking situations. The medication helps to control the patient's sympathetic nervous response so that it is not so intense as to cause the patient to avoid the situation used in the exposure. It sounds like this patient needs a more aggressive medication regimen and a more aggressive CBT treatment course. The medication regimen can become more complicated if the patient does not tolerate the SSRI's or benzodiazepines well.

• Beware of sub-clinical of meds or tx! by Barbara Fleming, Ph.D., 9/21/97