Performance anxiety, or stage fright, is something everyone has experienced. No matter how prepared you are, you may feel nervous just before an important moment. Be it meeting the love of your life, going up on stage to give a speech, or receiving your examination results, the symptoms of anxiety can be uncomfortable. Even though you cannot buy anxiety pills over the counter in Singapore, there are some alternatives to seeing a doctor to prescribe it.
What is anxiety?
Anxiety is the body’s natural response to stress. It is a fear of what will come in the future. You may respond to things with dread and fear if you have anxiety.
Anxiety also causes physical symptoms like shivering, sweating, and a pounding heart.
The generalised anxiety disorder ratio jumped from 0.9% to 1.6% during 2010-2016 in Singapore.
Types of Anxiety:
Anxiety can be of different types, like:
Performance anxiety:
Performance anxiety is fear and dread about one’s ability to perform specific tasks. People suffering from performance anxiety anticipate failure even before the task begins.
Unlike generalised anxiety disorder, performance anxiety occurs only before specific tasks like interviews, public speech, or stage performances.
Other kinds of anxiety are the panic disorder of sudden intense attack, phobias or fear about certain objects and situations, social anxiety or social phobia, and separation anxiety.
Generalised anxiety disorder (GAD):
Generalised anxiety disorder is constantly worrying about happenings and situations that interfere with day-to-day work. The cause of worry may be finance, family, work, health, future, or anticipation of any disaster. People suffering from GAD find it difficult to get rid of the worry.
Different types of anxiety pills:
Following are the commonly used anxiety pills all over the world.
Beta-blockers:
Beta-blockers are originally used to treat heart conditions, but they can be used off-label to treat performance anxiety.
Beta-blockers act by blocking the effect of stress hormones like adrenaline.
Beta-blockers have short-term effects and are used before performing any particular task like public speaking and interviews. This drug class includes propranolol, acebutolol, and metoprolol4.
Selective serotonin reuptake inhibitor (SSRI):
SSRIs work by increasing serotonin levels in the body. Serotonin is a neurotransmitter that regulates mood, sleep, happiness, sexual desire, memory, and appetite. SSRIs have long-term effects, and these are used at lower doses initially. SSRIs show results 2-6 weeks after the onset of medication; some people may take 6-12 months to show recovery3.
SSRIs include paroxetine, sertraline, escitalopram, and fluoxetine drugs. SSRIs are considered the first line of treatment for anxiety. The best thing about SSRIs is that these medications do not cause dependence or addiction in patients. These anxiety pills are not available over the counter in Singapore, so a prescription is mandatory.
Other anti-anxiety drugs include:
Serotonin-norepinephrine reuptake inhibitors (SNRIs), tetracyclic antidepressants, monoamine oxidase inhibitors (MAOI), N-methyl-D-aspartate (NMDA) Receptor Antagonists, and benzodiazepines.
Prescription is required to purchase anxiety pills:
So, the first question that would pop up in your mind will be, “Are these anxiety pills over the counter in Singapore?”
No, they actually require a prescription from a physician, psychiatrist, or mental health professional.
SIRE is licensed to prescribe beta-blockers like propranolol.
A licensed healthcare professional will examine you and prescribe an appropriate anti-anxiety drug depending on the severity of your symptoms.
Can I get these online?
Yes! You can get anti-anxiety drugs by following these three easy steps on thesire.sg
Survey: Start your treatment today by telling us how you are suffering through our online survey. Our in-house doctors will review your details within 24 hours.
Consult: We will confirm your condition through WhatsApp and consult you on whether the available treatment suits your condition.
Can you use Benadryl (diphenhydramine) for anxiety? If you are living with anxiety and don't like traditional medications or have not yet visited your doctor, you might wonder whether over-the-counter (OTC) medications like Benadryl might help you manage your symptoms.
But there are many questions: Are they safe? Do they work? What are the pros and cons? And, can you use them to supplement other treatments you might receive? This article considers each of these questions to help you sort through your options for treating anxiety with over-the-counter medication like Benadryl.
Other OTC Medications for Anxiety
First things first: You're probably wondering if over-the-counter medications even work when it comes to treating anxiety. In order to answer this question, let's first consider the different over-the-counter medications that you might use for anxiety because Benadryl is just one of many.
Antihistamines and Other Sedatives
Antihistamines such as diphenhydramine, the active ingredient in Benadryl, are used to manage allergic reactions, but they can also cause sedation as a side effect. Because of this, diphenhydramine is in a lot of over-the-counter sleep aids. Some people take Benadryl for anxiety because of the calming side effects it can have. In fact, some doctors may even prescribe Benadryl for children and adolescents with anxiety disorders, according to the American Academy of Child and Adolescent Psychiatry (AACAP).
Benadryl takes about 15 to 30 minutes to start working and its peak effect occurs about 2 to 4 hours after taking it. An adult dose to obtain sedating effects is between 25 and 50 milligrams. However, these effects are less than you would experience with prescription sedatives such as benzodiazepines.
In addition to the sedating effects of antihistamines, other over-the-counter drugs can induce sedation and drowsiness, most notably those marketed as muscle relaxers or sleep medications.
Benadryl is not the only antihistamine that is sometimes used off-label for anxiety relief. Doctors may also sometimes prescribe Vistaril (hydroxyzine), an antihistamine that is similar to Benadryl, for the short-term treatment of anxiety.
Herbal Remedies
There are a number of herbal remedies that may provide some relief of symptoms of anxiety. Some of these include:
- Chamomile
- Lavender
- Lemon balm
- L-theanine
- Passionflower
- Skullcap
- Valerian
Herbal remedies can be found in the form of teas, sprays, pills, oils, or tinctures. Like other treatments for anxiety, herbal remedies can also have calming effects, but they are generally mild.
These herbal remedies are generally not strong enough to effectively treat acute anxiety symptoms. Herbal remedies are best used under a doctor's guidance to complement other first-line treatments for significant anxiety.
Painkillers
Various painkillers may act on parts of the brain involved in the experience of emotional pain. In fact, one study from the University of British Columbia concluded that over-the-counter medication such as Tylenol (acetaminophen) had an impact on emotional distress and anxiety triggers.
Vitamins and Minerals
Most people know that vitamins and minerals are important for physical health, but can taking them reduce anxiety? Unfortunately, unless you have a deficiency in a particular vitamin or mineral, it's unlikely that taking vitamin or mineral supplements will reduce anxiety symptoms. That being said, there is no harm in taking a daily multivitamin to support your overall health under the guidance of your doctor.
Herbal Supplements Used for Social Anxiety
Safety of OTC Medications for Anxiety
The safety of using over-the-counter medication for anxiety generally depends on what you take and how you use it. Some of the safety concerns to consider include:
- Drug interactions: Always tell your doctor what OTC medications and supplements you are taking, as there is always a risk of interaction among supplements or with other medicines you might be taking.
- Intended use: Most over-the-counter medications that you might take for anxiety, such as antihistamines, while approved by the Food and Drug Administration (FDA) as safe, have not been approved for alleviating symptoms of anxiety.
- Long-term effects: Most OTC medications and supplements are intended to be taken only periodically, and there is little to no research on long-term use. As a result, they carry risks for side effects when taken regularly, and there is potential for misuse.
- Regulation: Herbal supplements are not regulated in the same way as medications, and long-term studies on efficacy and safety are often lacking. However, most supplements are safe to use under the guidance of a physician.
- Side effects: For some supplements, such as kava kava, there is concern about serious side effects such as liver damage. It is important to be aware of the potential side effects of any herbal supplements you take and to contact your doctor if you experience any.
- Potential for overdose: Though rare, there is a potential to overdose on OTC medications if you take too much. Be sure to take only the recommended dose, and store your medications somewhere out of reach of children. Even in the case of OTC medications and supplements, taking too much can be dangerous and even deadly.
In the case that you take too much Benadryl and are at risk of overdose, seek emergency help. You can contact Poison Control Centers 24 hours a day at 1-800-222-1222. Overdose can lead to rapid heart rate, not being able to urinate, blurred vision, agitation, confusion, drowsiness, and unsteadiness among other symptoms. Those that require immediate help include trouble breathing, hallucinations, seizures, and unresponsiveness.
Pros and Cons of OTC Medicines for Anxiety
While there are some advantages to taking OTC remedies for anxiety, there are also a number of potential drawbacks to consider. Before you take any kind of OTC medication for your anxiety, be sure to talk to your doctor to help avoid adverse effects and harmful medication interactions.
Pros
Risk of dependence and withdrawal is less than for certain prescription sedatives
May aid sleep and relaxation
Easy and inexpensive to obtain
Potentially useful for short-term episodes of anxiety
Potentially useful if you are against taking traditional medications for anxiety
May be helpful to supplement other treatments such as psychotherapy
Cons
Potential to cause drowsiness during the day
Not effective for severe anxiety
Not approved by FDA for treating anxiety, or not regulated by FDA
Not meant for long-term use for anxiety
Potential side effects
Advantages
Benzodiazepines, a type of prescription medication that is commonly prescribed to manage symptoms of severe anxiety, can lead to dependence, tolerance, and withdrawal, particularly when they are taken regularly for a longer period of time, so OTC options can be an appealing choice for people who are worried about this potential with these anti-anxiety medications. OTC remedies are less likely to present this type of risk, although diphenhydramine does have some potential for misuse.
One of the biggest advantages of using an OTC medication such as Benadryl to treat anxiety is that it is fast-acting and convenient. These qualities can be helpful if you need to reduce symptoms of mild anxiety quickly. Because Benadryl causes many people to feel drowsy, it can also help with sleep.
Disadvantages
It is also important to remember, however, that antihistamines like Benadryl can also have unpleasant side effects. Some people may experience severe drowsiness, fatigue, and dizziness.
It's also important to remember that these OTC remedies should not be used to treat severe anxiety or as a long-term solution. These medications and supplements are also not approved by the FDA for the treatment of anxiety. If you are experiencing symptoms of anxiety, talk to your doctor about your treatment options to ensure the best treatment plan for you.
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OTCs to Supplement Other Anxiety Treatments
Other types of treatments for anxiety might include talk therapy (such as cognitive behavioral therapy, mindfulness, and acceptance-based therapy) and prescription medications (such as benzodiazepines or selective serotonin reuptake inhibitors).
You can theoretically use over-the-counter medications for anxiety while receiving other treatments. But first, ask yourself why. Some common reasons to continue to use over-the-counter remedies alongside other treatments include:
- You are in therapy and need some additional relief from your acute symptoms but you are wary of taking a prescription medication.
- You are taking a prescription medication, but are waiting for it to take effect and need short-term relief.
- You are already using an alternative treatment and want to add over-the-counter medication to your treatment plan.
In all these cases, it's likely that you will be better off consulting with your doctor. They can help you determine the best course of treatment for you. If you are only receiving talk therapy and want a short-term solution for mild anxiety that bothers you mostly at night, then an over-the-counter solution might be helpful, though it's best to consult a physician first.
Never combine an over-the-counter medication with prescription medication for anxiety without the advice of your doctor, as there is the possibility of medication interaction and negative side effects.
Who Should Use Over-the-Counter Medications?
A study of 690 German pharmacists determined that people seeking over-the-counter treatments for anxiety and depression:
- Were more likely to be younger
- Had a shorter duration of illness
- Had less severe symptoms
- Were skeptical about psychopharmacology
However, the researchers questioned whether OTC treatments were a logical or cost-effective solution to these problems. Most people purchasing over-the-counter treatments for anxiety would likely benefit from professional help in the form of talk therapy or prescribed medication. The exception might be for cases of very mild anxiety that seem to be helped by herbal remedies that offer relaxation at bedtime.
Though some doctors may recommend OTC medications like Benadryl for children and adolescents, it's especially important not to give a child Benadryl to treat anxiety without consulting their doctor first. Diphenhydramine can be potentially dangerous, and may not be the best course of treatment for your child's symptoms.
A Word From Verywell
While it may seem like a quick and easy solution to run to the drugstore and pick up an antihistamine to take the edge off when your anxiety symptoms worsen, there are risks associated with using OTC medications, particularly when using them off label for symptoms they are not intended to treat.
Be sure to discuss your symptoms and any OTC treatment options you're considering with your doctor or mental health professional. It's always best to get guidance from your provider about using OTC medications and herbal supplements before starting a new treatment to ensure you get the right treatment for you.