Anti-anxiety Medication

Our son, age 21, has a high anxiety level. What medications would be a good replacement for Valium, to which he is sensitive and lacks tolerance?

There are lots of anti-anxiety medications for kids — most have the common side effects of 1) sedation (which the child may “fight” and generate paradoxical agitation) and 2) disinhibition– which may unmask more troublesome behavior which was being “controlled” before.

I suggest very low doses of neuroleptic (drug inducing an altered state of consciousness) such as 0.125 to 0.25 mg of Risperdal, 1 mg to 2.5 mg of Zyprexa, or 12.5 mg of Seroquel if the “anxiety” is really mild agitation in familiar situations. Of the true “anti-anxiety” drugs, perhaps a trial of Ativan (lorazepam) at micro doses (0.25 mg to 0.5 mg). Lastly, there is Buspar (buspirone) which can reduce anxiety over a longer period — but which has side effects of stomach distress and may not be tolerated. Classic “sleepers,” like Chloral hydrate, etc., are not good anti-anxiety agents.

DS/TK 7-13-10

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