Areas › Worry and anxiety › Treatment and medication
The gentler alternatives are for avoiding a habit forming medicine in the first place. They cannot carry someone who is already dependent, and offering one as a straight swap mid crisis sets everybody up to fail.
Once a body has adapted to one of these medicines, only a careful reduction of that same medicine will get a person off it, and a different drug will not cover the gap. So keep the two jobs apart: choosing something for the anxiety, and planning a taper. Both can happen at once, but running them together makes a hard taper look like proof that the alternative was useless.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
Do not despair of God's mercy (Quran 39:53). Someone who has become dependent on a prescribed medicine has not fallen out of reach of help, and what they need is a different plan rather than a verdict.
۞قُلۡ يَٰعِبَادِيَ ٱلَّذِينَ أَسۡرَفُواْ عَلَىٰٓ أَنفُسِهِمۡ لَا تَقۡنَطُواْ مِن رَّحۡمَةِ ٱللَّهِۚ إِنَّ ٱللَّهَ يَغۡفِرُ ٱلذُّنُوبَ جَمِيعًاۚ إِنَّهُۥ هُوَ ٱلۡغَفُورُ ٱلرَّحِيمُ
Say, ‘[God says], My servants who have harmed yourselves by your own excess, do not despair of God’s mercy. God forgives all sins: He is truly the Most Forgiving, the Most Merciful
Qur’an 39:53read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
Work in general practice on withdrawing long term sedatives documents real costs to memory and coordination while they are being taken, and finds that coming off them gradually and with support is usually followed by better functioning, particularly in older people. Gradually and with support are the working words in that sentence. It describes people already taking them, which is exactly the group that a straight substitution lets down.
Lader M, Tylee A, Donoghue J. (2009). Withdrawing benzodiazepines in primary care.. CNS drugs doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A different medicine cannot stand in for the one a body has already adapted to.
When not to
A taper is a prescriber's task, and stopping this class of medicine abruptly can be dangerous.
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
Ask what symptom you are aiming at rather than what the diagnosis is called. Nothing anyone takes recognises a category; it acts on whatever is happening in the body.
A small dose that has not changed in years is not automatically something to fix. Stopping carries risks of its own, and they have to be weighed rather than assumed away.
One medicine can reach both the surging kind of anxiety and the circling kind, while another really only touches the surging kind. That is why the slower and broader option is usually the one people are started on.