Anxiety

Anxiety is common in MS, and may be related to depression. In many cases, medications used to treat depression will also alleviate symptoms of anxiety. A recent study at the University of Washington indicated that about one-quarter of all people with MS experience anxiety, and most of them also experience depression.

Non-Pharmacologic Management

As with depression, and because of the wide range of issues that can contribute to depression, the most effective results are usually obtained with a combination of "talk therapy" (counseling) and pharmacologic agents.

A number of relaxation and therapeutic therapies can also be very helpful in reducing anxiety. Among others, these include exercise, biofeedback, guided imagery, self hypnosis, yoga, tai chi, and massage.

Pharmacologic Management

Benzodiazepines
including Valium® (diazepam), Serax® (oxazepam), Ativan® (lorazepam), Klonopin® (clonazepam), and Xanax® (alprazolam)

Valium was the first benzodiazepine approved by the FDA for the treatment of anxiety, and most of the agents used to manage this symptom in MS are derivatives of this drug.

Doses vary depending on the specific molecular structure of the diazepam derivatives. All are useful in treating anxiety and panic disorders, as well as the anxiety that is directly related to depression; these conditions are normally treated as a single entity. These drugs must be carefully monitored as they may cause dependence.

Side effects include confusion, depression, drowsiness, insomnia, light-headedness or dizziness, headache, urinary difficulties, and tremor. Habituation - a decrease in response after repeated use - is a concern.