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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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