What Medications Are Used to Treat Agoraphobia?
Key takeaways:
Agoraphobia is a condition where you feel an intense fear or anxiety about certain situations or places. You feel as though there’s no way to escape.
People with agoraphobia try to avoid these situations or places. In severe cases, some people avoid leaving their house altogether.
Medications, psychotherapy, and lifestyle changes can help relieve symptoms.
Imagine walking into a crowded grocery store and suddenly your heart begins to race. You feel sick to your stomach and like you will pass out at any second. Has this ever happened to you? Have you experienced a fear so intense that it caused you to avoid a place altogether?
This is an example of what it might feel like for someone with agoraphobia. Agoraphobia is ananxiety disorder where you have fear or anxiety about a situation or place that makes you feel trapped. It’s estimated that almost 1% of U.S. adults have experienced agoraphobia in the past year.
Treatment can help manage symptoms and improve quality of life. Read on to learn more about the medications used to treat agoraphobia.
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What is agoraphobia?
Agoraphobia is an anxiety disorder where you avoid certain situations or places. This is because you experience fear or anxiety due to feeling like there’s no escape. It’s often associated with an existing panic disorder.
Diagnosis usually occurs in early adulthood, and the exact cause is unknown. But there are a few factors that might raise the risk of developing agoraphobia. These include existing anxiety disorders, traumatic childhood events, and genetics.
Depending on the severity, it can interfere with personal relationships, work, or school. Some people with agoraphobia can navigate daily activities by avoiding triggering places. But others may remain completely homebound.
People with agoraphobia may experience a panic attack when in a stressful situation. Symptoms of a panic attack may include nausea, fast heartbeat, or dizziness. This can add to their fear of going out to places or being in certain situations.
How is agoraphobia diagnosed?
Agoraphobia is diagnosed based on a few conditions. First, you need to have fear or anxiety about at least two of the following situations:
Being in open spaces
Being in enclosed spaces
Using public transportation
Standing in line or in a crowd
Being outside your home by yourself
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Additionally, these feelings need to persist for at least 6 months. Being in these situations almost always causes fear, anxiety, or avoidance. This is because you feel like you can’t escape or get help. And the amount of fear or anxiety you’re feeling is uneven given the situation. It also significantly affects activities you do outside of your home.
What medications are used to treat agoraphobia?
There aren’t any FDA-approved medications specifically for agoraphobia. But several different antidepressants may help relieve anxiety symptoms from the condition. They’re used off-label, meaning they’re used in a way that’s not FDA approved.
Antidepressants have some overlapping risks to know about:
Risk of suicidal thoughts and behaviors: All antidepressants have a serious warning about raising the risk of suicidal thoughts and behaviors. This risk is higher in children and young adults under age 25. Your healthcare provider and family should watch for mood changes after you start the medication or change the dose.
Serotonin syndrome: Although rare, these medications can sometimes cause a life-threatening condition called serotonin syndrome. This risk goes up if they’re taken with other medications that also affect serotonin. Tell your healthcare provider and pharmacist about any other medications and over-the-counter products you’re taking. This can help prevent a serious interaction.
Next, let’s review three different antidepressant classes used to treat agoraphobia.
Selective serotonin reuptake inhibitors
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They work by affecting a brain chemical called serotonin. Serotonin is thought to regulate your mood.
SSRIs are typically considered first-choice treatments for agoraphobia. They’re also used to treat depression and anxiety disorders (including panic disorders). A few examples include fluoxetine (Prozac), citalopram (Celexa), and escitalopram (Lexapro).
Common side effects of SSRIs include:
Headache
Dry mouth
Sleeping problems
Dizziness
Gastrointestinal (GI) problems
Sexual side effects (e.g., erectile dysfunction)
Serotonin and norepinephrine reuptake inhibitors
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are antidepressants that work by affecting serotonin. But they also affect another brain chemical — called norepinephrine — to help regulate mood. SNRIs are often prescribed to treat depression, anxiety disorders, or long-term nerve pain.
Like SSRIs, SNRIs can help with the anxiety symptoms. But they tend to have more side effects, which is why SSRIs may be preferred. A few examples of SNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor).
Common side effects of SNRIs include:
Nausea
Sleeping problems
Headache
Dry mouth
Sexual side effects
Tricyclic antidepressants
Tricyclic antidepressants (TCAs) are also classified as antidepressants. Like SNRIs, they work by affecting both serotonin and norepinephrine. TCAs are often prescribed to treat depression, anxiety disorders, and nerve pain.
As with the other medications we’ve covered, TCAs may be used to help with anxiety symptoms. But they tend to be used less often due to their side effects. A few examples include nortriptyline (Pamelor), amitriptyline, and imipramine (Tofranil).
Common side effects of TCAs include:
Constipation
Dizziness
Dry mouth
Blurred vision
Other medications
Other anxiety medications are sometimes used to help with symptoms. This includes benzodiazepines like alprazolam (Xanax). They might be used while you’re starting an antidepressant or to treat a panic attack. But they’re typically used short term since they can cause dependency.
Which antidepressant works the best for agoraphobia?
If your agoraphobia is mild to moderate, you may not need to take medication. In this case, psychotherapy, like cognitive behavioral therapy (CBT), may be enough. CBT is a type of talk therapy that helps you recognize and change thoughts and behaviors. But if it isn’t working, or if your symptoms are more severe, adding a medication may help.
SSRIs and SNRIs are usually first-choice medications for anxiety disorders like agoraphobia. This is because they tend to have fewer side effects than other antidepressants. But they can take up to 6 weeks to start working. Keep in mind that you may need to try more than one before you find a medication that works.
Older antidepressants like TCAs aren’t usually the first choice due to side effects. But your healthcare provider might have you try one if SSRIs or SNRIs aren’t working or if you can’t take them.
What are some other tips for coping with agoraphobia?
There are several treatment options for agoraphobia. Sometimes, a combination of treatments may be needed. And there are some self-care things you can do to help, too. Below are some tips you can use to take care of your mental health while you’re going through treatment.
Examples of lifestyle changes you can put in place include:
Practicing daily meditation or breathing exercises: Meditation can help lower your stress and allow you to relax. If you’re not sure where to start, click here to learn more about meditation apps that might help.
Eating a healthy diet: What you eat can affect your mental health. Plus, caffeine in coffee or other beverages can potentially worsen anxiety. Take steps towards incorporating healthy foods and limiting your caffeine intake.
Exercising regularly: Exercise can provide stress-relieving benefits. Whether it’s a 10-minute walk, bike ride, or fitness class, exercise in a way that works for you.
Get enough sleep: Sleeping problems can cause anxiety, and vice versa. Work on establishing a consistent bedtime routine to get at least 7 to 9 hours each night. Click here for more tips on how to get better sleep.
The bottom line
Agoraphobia is a condition where you experience fear or anxiety about places or situations where you feel trapped. It’s unknown what causes it. But there are treatment options available to help with symptoms and improve quality of life.
Psychotherapy can help you work through thoughts that contribute to your agoraphobia. Medications, like SSRIs and SNRIs, can help alleviate anxiety symptoms. And lifestyle changes can have positive effects on your mental health, too.
If you’re experiencing agoraphobia symptoms, contact your healthcare provider. They can discuss the best treatment plan for you.
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References
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For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
