Substance/Medication-Induced Anxiety Disorder 229
lants (including cocaine), and other (or unknown) substances. Panic or anxiety can occur in
association with withdrawal from the following classes of substances: alcohol; opioids; sed-
atives, hypnotics, and anxiolytics; stimulants  (including cocaine); and other (or unknown)
substances. Some medications that evoke anxi ety symptoms include anesthetics and anal-
gesics, sympathomimetics or other bronchodilato rs, anticholiner gics, insulin, thyroid prep-
arations, oral contraceptives, antihistamines, antiparkinsonian medica tions, corticosteroids,
antihypertensive and ca rdiovascular medications, anticon vulsants, lithium carbonate, an-
tipsychotic medications, and antidepressant medications. Heavy metals and toxins (e.g.,
organophosphate insecticide, nerve gases, ca rbon monoxide, carbon dioxide, volatile sub-
stances such as gasoline and paint) may also cause panic or anxiety symptoms.
Prevalence
The prevalence of substance/me dication-induced anxiety disorder is not clear. General
population data suggest that it may be rare, with a 12-month prevalence of approximately
0.002%. However, in clinical populations,  the prevalence is likely to be higher. 
Diagnostic Markers
Laboratory assessments (e.g., urine toxicology) may be useful  to measure substance intox-
ication as part of an assessment for subs tance/medication-induced anxiety disorder.
Differential Diagnosis
Substance intoxication and substance withdrawal. Anxiety symptoms commonly oc-
cur in substance intoxi cation and substance withdrawal. The diagnosis of the substance-
specific intoxication or substance-specific wi thdrawal will usually suffice to categorize the