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Anxiety: Dr. Peter J. Rice

Anxiety and You!

Visiting Ireland has always been one of my life goals, and when my daughter invited my wife and I to travel to the Emerald Isle, of course we agreed.  Our group eventually expanded to include my older daughter and son, their spouses and our two grandchildren.  

One of the group, while anxious to visit Ireland, was also anxious about flying.

Bosco “BA” Baracus was a character in the 1980s TV series, The A-Team, played by Mr. T.”  The “BA” also stood for “bad attitude”, and although BA appeared to be ill-tempered, he was really kindhearted underneath.

BUT, BA did not like to fly – “I ain’t gonna getting’ on no airplane“ – and was adamant about not getting anywhere near planes or airports.  This set up the frequent slapstick situations in which BA was tricked and drugged before being put on a plane and awakening in a foreign country.  


There’s Help for Anxiety!

Anxiety is defined as a feeling of worry, nervousness, or unease, usually about an upcoming event or something with an uncertain outcome.

One of the most common events triggering anxiety is a public performance or speech, but for some patients it can be a visit to the dentist or a shopping trip; for some it can be getting married. Anxiety rises to the level of a mental health disorder when it interferes with one’s daily activities.

There are several approaches to treating anxiety.

  • Once the trigger is recognized, it is possible to work with patients to overcome anxiety by controlling individual responses through conscious training.
  • Toastmasters International can do remarkable things for those intimidated by public speaking.
  • Cognitive behavioral therapy can provide help in changing response patterns to things like stress and anxiety.

Understanding the body’s response to anxiety can allow patients to take a first step toward controlling their responses. The body responds to threats and anxiety by activating the sympathetic nervous system, which causes the heart to beat faster and activates the impulse to sweat. This response can be controlled by remaining calm, taking a deep breath and letting in out slowly. Try this biofeedback technique sometime.

Drugs can often help as well. Beta-blockers, such as propranolol, are given to performers and others who find themselves in occasional high-anxiety situations. Like the biofeedback described above, Beta-blockers act to slow the heart and decrease activation of the sympathetic nervous system.  

In our clinic, we often prescribe hydroxyzine, an older drug with central nervous system actions that help with anxiety.

The benzodiazepines are a class of drug that are used for a number of illnesses.  They are used to treat seizures, relax muscles, help patients get to sleep, control anxiety, or to forget procedures performed during the time the drug was present in the body. Among the different members of the benzodiazepine drug class, sometimes one or another of these activities will predominate.

For example, the benzodiazepine triazolam (Halcion™) had been used to help patients get to sleep and avoid jet lag, but some patients would wake up in their hotel room in a foreign country without any memory of how they got there.

Our “BA” was successfully treated with alprazolam (Xanax™), which produces a wonderful sleep during flight with some loss of memory of the flight and the anxiety. And each favorable flight experience can help minimize future anxiety episodes.

If you experience occasional anxiety, try the biofeedback technique described above and talk with your prescriber or pharmacist. There are behavioral and support programs as well as medicines which can help with occasional or prolonged anxiety. Your pharmacist can help optimize your drug therapy. 


PubMed Health: Anxiety

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Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association.




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