Reader’s Question

Is there a medication known to man, to treat chronic anxiety on a long term basis, which does not contain antidepressants? My body reacts negitively to antidepressants. Currently I am taking 200mg sertraline daily and I have such anxiety pain in my heart. I’ve been on this medication 2 months and my doctor keeps increasing the dosage, but it is not controlling the symptoms of anxiety.

Our Clinical Psychologist’s Reply

As I’ve discussed many times, about 85% of mental health medications (antidepressant, antianxiety, etc.) are prescribed by nonpsychiatrists — typically family physicians or OB/GYN physicians. Nonpsychiatric physicians often prescribe at an ineffective dose or don’t use combinations of medications.

Your current dosage of Zoloft, or sertraline, is aggressive — perhaps too aggressive considering the presence of chest pains. With the presence of chest pain and cardiac discomfort, I would immediately consult your physician as this may be a physical issue with using the medication. Zoloft is also a Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant — not an antianxiety medication. It can reduce anxiety as depression lifts but it is not designed as an antianxiety medication.

Treating chronic anxiety and depression is often accomplished with a multi-action newer medication such as Lexapro or Effexor. It can also be accomplished by adding a long-acting anti-anxiety medication such as Clonidine to your treatment program. Your best bet is to consult a psychiatrist who is trained to use these medications at maximum therapeutic dosage and in combinations.