Areas › Worry and anxiety › Treatment and medication
If you have been given a drug from one category for a problem in another, it is fair to ask which part of it is doing the work. Often the useful effect is a side effect that has been borrowed.
The common example is an antipsychotic given in a small dose for sleep, where the drowsiness comes from its antihistamine action rather than from anything to do with psychosis. That can still be a reasonable choice. It also brings the rest of the class along with it, including weight and metabolic effects, for something that might be had another way. The label on the box tells you less than the question of what it is doing in you.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
Ask people who know the Scripture (Quran 21:7). Asking is treated as the ordinary response to not knowing, rather than as a challenge to whoever does know.
وَمَآ أَرۡسَلۡنَا قَبۡلَكَ إِلَّا رِجَالࣰ ا نُّوحِيٓ إِلَيۡهِمۡۖ فَسۡـَٔلُوٓاْ أَهۡلَ ٱلذِّكۡرِ إِن كُنتُمۡ لَا تَعۡلَمُونَ
And even before your time [Prophet], all the messengers We sent were only men We inspired–– if you [disbelievers] do not know, ask people who know the Scripture––
Qur’an 21:7read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
The evidence for adding a second drug when the first has not worked is thinner than most people assume. A review of these strategies in anxiety that had not responded to treatment found the research limited and mixed, with no strong case for any particular combination. That is not a reason to refuse one, but an added drug deserves the same clear target and review date as the first.
Ipser JC, Carey P, Dhansay Y, Fakier N, Seedat S, Stein DJ. (2006). Pharmacotherapy augmentation strategies in treatment-resistant anxiety disorders.. The Cochrane database of systematic reviews doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Knowing which effect you are relying on tells you what you are paying for it.
When not to
Asking is for understanding your prescription, not for adjusting it yourself.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
If something helped one part of your anxiety and did nothing for the rest, that is not proof it failed or that you are beyond help. Different parts of this run on different machinery.
How well something works in the moment and whether it is right for the long run are two separate questions. Fast relief is extremely convincing, which is exactly why it is worth pausing over.
Some anxiety medicines have no fast setting at all. They work on the receiving side of the system and take two to four weeks to show anything, so taking one in a bad moment does nothing and proves nothing.