Is there a natural substitute for the benzodiazepines?

November 3, 2011 1:27 PM

Is there a natural substitute for the benzodiazepines?

I tend toward experiencing undue anxiety. The only drugs that really work for me are Klonopin and Ativan. But I don't want to take them too frequently, for obvious reasons. I'm reading that the mechanism the benzos use is involved with enhancement of the neurotransmitter GABA, which inhibits the overactivity of some of the other neurotransmitters. There are some over-the-counter preparations that talk about working to increase GABA, but my question is: do they really work?

Is there anything out there OTC that actually relieves anxiety? I find that Benadryl seems to have a bit of the same action, but also acts as a hypnotic (as do the benzos, actually, but they have a better anxiolytic/hypnotic ratio).

Thanks.

posted by DMelanogaster to Health & Fitness (26 answers total)

Valerian Root works for some people, either in capsules or brew a tea out of it. You can find the industrial capsule sort in any CVS/Walgreens/etc. The tea you'd probably have to go to a health store.
posted by griphus at 1:33 PM on November 3, 2011

I really do not believe there is any OTC that relieves anxiety as effectively or efficiently as benzodiazepines. If there were it could not be kept on the shelves. Most herbal remedies that purport to act on the same receptors breakdown before they can effectively cross the blood brain barrier. The two most common OTC are alcohol and cannabis which, as you know, have their own draw backs. Alcohol is certainly not recommended as an anti-anxiety agent as its effects are short lived, works as a depressant and has serious potential problems with dependence and tolerance. The first line treatment is actually use of an SSRI/SSNRI as they are quite effective in managing anxiety. However, they have to be taken consistently and the user must get through the first 2 weeks +/- when there are often unpleasant side effects--including increased anxiety. However, they are remarkable effective--if the first one prescribed does not work with in 30 days +/- doses may be increased are another prescribed. Good Luck
posted by rmhsinc at 1:53 PM on November 3, 2011 [2 favorites]

There's kava, but it can cause liver failure. Be careful to avoid it when picking up OTC supplements that claim to relieve anxiety.
posted by Ery at 1:56 PM on November 3, 2011

Synthetic GABA is available for purchase in the US. I had a therapist once who recommended it as an anxiolytic. I've taken it a few times and it's not nearly as effective as a benzo, but it does a subtle job of taking the egde off of certain situations. This is the brand I've used. It might not be as strong as you'd like, but it's worth a shot.
posted by Mrs.Spiffy at 2:16 PM on November 3, 2011

Oh, and in case I wasn't clear, it is available OTC.
posted by Mrs.Spiffy at 2:17 PM on November 3, 2011

Rhodiola rosea is a natural MAOI which has anxiolytic effects. Combined with aerobic exercise, I found it pretty effective at taking away the worst of my anxiety.
posted by CutaneousRabbit at 2:23 PM on November 3, 2011

Valerian Root works for some people, either in capsules or brew a tea out of it.

Can't say whether or not it compares, but valerian extract helped immensely with my anxiety and insomnia. I like the one from Mountain Rose Herbs. Tea is insanely bitter and hardly drinkable, capsules take too long for the before-bedtime dose for me.

Some herbalists seem to think it takes about a week or two for the effects to begin, with me it works within a few days or so.
posted by oneirodynia at 2:35 PM on November 3, 2011

I tend toward experiencing undue anxiety. The only drugs that really work for me are Klonopin and Ativan. But I don't want to take them too frequently, for obvious reasons.

Oh yay, me too. For me what works is to up my exercise and B vitamins in the long term, so as to lessen the amount of times I will need to take the benzos. But if I really need 'em, I need 'em, and nth that there is no subsitute.
posted by sweetkid at 2:48 PM on November 3, 2011 [1 favorite]

Response by poster: Thank you, these are great answers. I wonder, mrs.spiffy, if the GABA in a bottle crosses the blood-brain barrier (enough). I guess I"ll try.

Are there any scary side effects/consequences of valerian root?

I have upped my aerobic exercise just recently, and am wondering if that'll help.

I actually wouldn't mind taking the Klonopin more but I don't think my doctor will prescribe more. (I usually manage to get a prescription for 30 every 6 months or so.)
posted by DMelanogaster at 3:15 PM on November 3, 2011

Response by poster: oh, I also wanted to say that I've never been able to get past the first couple of weeks of an SSRI. I feel so awful when I take them. I also don't want to gain weight. And I know so many people who remained anxious (and depressed) on them.
posted by DMelanogaster at 3:16 PM on November 3, 2011

I actually wouldn't mind taking the Klonopin more but I don't think my doctor will prescribe more. (I usually manage to get a prescription for 30 every 6 months or so.)

Why won't your doctor give you more? Or why do you think the doctor won't? That's not a lot. I usually get 30 for 30 days if I need ( that's my max script). But I don't take them that often, because they get you hooked like whoa.
posted by sweetkid at 3:24 PM on November 3, 2011

Give Oat Straw tea a shot. Also, try working in some yoga a couple of times a week.
posted by cwarmy at 3:43 PM on November 3, 2011

People giving suggestions are obviously trying to help but, really, the answer is that there is no natural substitute for benzodiazepines. They are both safe and hugely effective in the short term. Far more effective than the things being suggested and probably safer. Shame about the long term dependency and side effects.

I know that's not really the answer you are looking for but it is the truth. Benzos don't have a good OTC substitute. Or a bad one, really.
posted by Justinian at 3:53 PM on November 3, 2011 [4 favorites]

I'm another person who uses Valerian for anxiety. I works as well for me as Klonopin wafers did.
posted by TooFewShoes at 4:25 PM on November 3, 2011 [1 favorite]

Try L-theanine made with Suntheanine. It won't make you feel like a benzo does, but it might prevent the anxiety from happening as badly in the first place. I take kava, btw, and so far my liver is fine. And it really works. Again, not as well as a benzo, but the effect is noticeable.
posted by xenophile at 4:28 PM on November 3, 2011 [1 favorite]

Valerian worked for my insomnia really, really well in the tea form. The pills are less of a sure thing (and smell horrible). I feel like I built up a tolerance over time, but this is all anecdata anyway, right?
posted by Medieval Maven at 5:31 PM on November 3, 2011

I did some research a couple of years ago and taking niacinamide daily (a B-vitamin) is supposed to relieve anxiety.
posted by IndigoRain at 6:00 PM on November 3, 2011 [3 favorites]

Dramamine or Benadryl, in a pinch. Not "natural" per se but they are OTC. I had to stop using benzos and I only use Valerian once in a while, since I've heard anecdotally that it can be habit forming. Also it smells to high heaven, like a wet dog that ate some gnarly garbage.
posted by wowbobwow at 6:02 PM on November 3, 2011

Regarding SSRIs - I didn't want to mention them since they don't answer the call of your question, but since you brought them up - there are a lot of different SSRIs, and a lot of different families of anti-depressants that might also help with anxiety in a long-term kind of way. Maybe you've tried several, but if you haven't, you might want to try a couple more. Side effects vary a LOT from drug to drug, and there's probably one out there that would help with your anxiety with no-to-minimal side effect (including no weight gain).
posted by insectosaurus at 6:17 PM on November 3, 2011 [1 favorite]

Are there any scary side effects/consequences of valerian root?

Here's what the American Cancer Society has to say about valerian side effects:

Valerian is considered to be relatively safe when used in recommended doses during 4 to 6 week periods. However, some people may notice restlessness and heart palpitations, especially with long-term use of valerian. Long-term or excessive use is not advised because of possible side effects, which include headaches, blurred vision, heart palpitations, and nausea. A few people become excitable and unable to sleep when they take valerian. Rarely, liver damage has been linked to valerian, although it is uncertain whether valerian, contaminants, or other herbs caused the damage. Those who take valerian should tell their doctors so that their liver function can be monitored. Allergic reactions may also be possible.

Valerian should not be taken with alcohol, antihistamines, muscle relaxants, sedatives, anti-seizure drugs, narcotics, or any drugs used in treatment of mental illnesses. People on cancer treatment medicines, anti-fungal drugs, allergy drugs, or medicines for high cholesterol should talk with their doctors or pharmacists about possible drug interactions before taking valerian. Because valerian may interact with anesthetics, people who are going to have surgery should not use valerian. However, suddenly stopping the herb has caused withdrawal symptoms in some people, so the dose of valerian should be tapered slowly, starting several weeks before surgery. Always tell your doctor and pharmacist about any herbs you are taking.

People with liver or kidney disease should talk to their doctors before taking valerian. In very high doses, the herb may weaken the heartbeat and cause paralysis. Women who are pregnant or breast-feeding should not take valerian. Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.
posted by oneirodynia at 6:48 PM on November 3, 2011 [2 favorites]

The drug free cure for anxiety is psychotherapy and it has been proven effective in most cases. Progesterone is way more effective than valium. Without knowing what kind of anxiety, it is hard to focus on a cure or symptom remedy. Is it mostly physical or worry?
posted by provoliminal at 7:45 PM on November 3, 2011

Lamictal is not OTC, not a benzo and not an SSRI. However. I used to take klonopin almost every day, but since getting the dosage right on Lamictal, I've barely taken it at all.

Obviously, talk to your doctor.

The only "natural" thing that I've tried and has worked is breathing techniques. Most basic meditation manuals cover this adequately, as does the Anxiety and Phobia Workbook.
posted by desjardins at 7:36 AM on November 4, 2011

I wonder, mrs.spiffy, if the GABA in a bottle crosses the blood-brain barrier (enough). I guess I"ll try.

The recommended dose is fairly high (800-1000 mg), but even so I'm not sure if the results I felt were placebo or a genuine drug effect. When I take 2 500mg capsules the most noticeable result is a reduction in muscle tension associated with anxiety. Once I took 3 capsules and my skin got all tingly, so I like to think the pills have some legitimate effect, but I can't really say for sure. The pills are inexpensive (I think I paid $10 for a bottle), so it's not a huge loss even if it doesn't work for you.
posted by Mrs.Spiffy at 11:28 AM on November 4, 2011

Best answer: I've tried everything (and more) mentioned above and they all work to some degree, but the main problem is that most make me really drowsy - which I consider a non-solution for functioning during the day.

I was lucky enough to stumble upon Niacinamide - a non-flushing form of niacin (B3), that seems to have some affinity for GABA receptors that benzos act upon. You can find this at most health food / vitamin stores. 1000mg of this twice a day has dramatically reduced my anxiety. I combine this with taurine and theanine to potentiate the effect (both taurine and theanine act slightly differently in their anxiolytic effects, so their benefits combine well). My first time taking a large dose I almost felt drunk, and with chronic use that effect went away - leaving behind a calm stable feeling.

I've read about Niacinamide being used for benzo withdrawals, so the effect makes sense to me. Make sure to limit daily intake to 3g or less.

A few hours before bedtime I take a combination of calming supplements that also cause drowsiness - ashwaghanda, glycine, lysine, arginine, magnesium/calcium, and 5-HTP. Valerian is a good bedtime addition as well.
posted by pickingoutathermos at 12:31 PM on November 4, 2011 [2 favorites]

Seconding pickingoutathermos' magnesium rec. It's not quite "nature's Xanax," but it does do something. Watch out for a rather loose GI situation, but not horrible.
posted by skbw at 3:05 PM on November 4, 2011

Response by poster: My anxiety tends to be needless worry (rumination). I am a mental health professional (non-medical) and a zillion-year veteran of psychotherapy, which didn't "cure" my anxiety (but it's a hell of lot better than it used to be). I know about breathing techniques, and they help somewhat, but I need to calm down all those pesky "What if....??" thoughts. I don't feel anxious all the time and don't want to take SSRIs every day. Thank you for all the recommendations!
posted by DMelanogaster at 1:20 PM on November 6, 2011