While each anxiety disorder has different symptoms, many people can benefit from a two-pronged approach consisting of psychotherapy (talk therapy) and medication.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293d10fdc1-0311-4b71-966e-541d0f97bb83 Each person may need a different combination of these elements, and in different sequences. “There’s no magic in the treatment of anxiety,” says Ken Duckworth, MD , the chief medical officer for the National Alliance on Mental Illness and an assistant professor of psychiatry at Harvard Medical School in Boston. “Some people will get better with psychotherapy alone, while some people might need medication to help them concentrate better on the therapy.” Also, says Dr. Duckworth, someone may need more than one medication. Here’s what medication treatment for anxiety disorders can look like.
Antidepressants Which Antidepressants Are Used for Anxiety? The two classes of antidepressants most commonly used to treat anxiety disorders are selective serotonin reuptake inhibitors (SSRIs ) and serotonin-norepinephrine reuptake inhibitors (SNRIs ). Examples of SSRIs include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629c5388ae6-5a1f-4a52-998e-bcfc0cae91d1 fluoxetine (Prozac) citalopram (Celexa) sertraline (Zoloft) fluvoxamine (Luvox) paroxetine (Paxil, Paxil CR, Paxeva, or Brisdelle) escitalopram (Lexapro) Examples of SNRIs include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976298ea2b61b-2604-41c4-bda5-fa3b5659df2f venlafaxine (Effexor XR) duloxetine (Cymbalta) desvenlafaxine (Pristiq) levomilnacipran (Fetzima) Other antidepressants that may be prescribed for anxiety include norepinephrine-dopamine reuptake inhibitors (NDRIs):e60dc2a1-f33c-4a05-9b50-8e3e8e59762951c0c25d-f8f9-4720-840d-36d904e9bb02 bupropion (Wellbutrin SR, Wellbutrin XL, Aplenzin, Budeprion SR, Budeprion XL) Common side effects of antidepressants include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a1d6ac6f-be58-46ff-9983-03492ce55770e60dc2a1-f33c-4a05-9b50-8e3e8e597629506f8f1b-b46d-46b6-a867-a8f59dc2b939 Nausea Diarrhea Sexual side effects Headache Dry mouth Difficulty sleeping Dizziness Fatigue Some people respond better to some antidepressants than others. You may need to try a few different medications before you find one that works for you.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291d5c09f1-6fab-44d8-a9bd-ee8a74c01c9d
Medication Basics Anxiety Disorders and Medications: The Basics There are several types of medications used to treat anxiety disorders. Antidepressants Benzodiazepines Other medications Within each of these categories, there are subgroups of drugs that work differently and have their own benefits, risks, and possible side effects. Antidepressants are often used as the first line of treatment. SSRIs, or selective serotonin reuptake inhibitors, are the most prescribed type of antidepressant. They impact serotonin, a neurotransmitter that has been linked to mood.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f93441a4-cdf8-4280-a6fa-7c5a278f8515e60dc2a1-f33c-4a05-9b50-8e3e8e597629a667ab51-1664-4405-8a11-434318b9cb01 Antidepressant medications often take two to eight weeks to be fully effective.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298e7258e9-fa75-44ba-a7cf-03f6ebd556b7 “[SSRIs are] super effective in treating anxiety disorders [for certain people],” says Beth Salcedo, MD , the medical director of the Ross Center in Washington, DC. It’s not known exactly how SSRIs work on serotonin to alleviate anxiety, says Dr. Salcedo, but what is known is that they’re not addictive like benzodiazepines are, though they can cause uncomfortable symptoms if people stop taking them abruptly. It’s important to follow your doctor’s instructions when taking any prescription drug. Talk to them if you’re concerned about the side effects of a medication or if the drug you’re taking doesn’t seem to be alleviating your symptoms.
Other Medications What Other Medications Are Prescribed for Anxiety? Buspirone is typically used to treat generalized anxiety disorder . It is often prescribed with an antidepressant. Side effects of buspirone may include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ec80a5dc-6e40-4986-a8a1-0acfb3a3b3ae Drowsiness Dizziness Headaches Nausea Light-headedness Changes in dreams Some people with phobias, panic disorder, or situational anxiety may be prescribed a heart medication known as a beta blocker . These drugs are primarily prescribed for irregular heartbeat and high blood pressure, but they have been found to be helpful for treating the feelings that come with high-pressure situations.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296b97db55-9715-4d29-abdb-224d379aa4d2 “Beta blockers can be very helpful but in a limited way,” says Salcedo. “They are most commonly used for performance anxiety. They are really good for the physical symptoms such as heart racing, sweating, and shakiness, but they work less well for the anxious thoughts that might be causing the symptoms.” Beta blockers are prescribed to be used on an as-needed basis; they’re not taken long-term.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b49de041-5847-4a1e-b3b1-0e0903106388 Hydroxyzine (Vistaril) is another medication prescribed for anxiety. It’s an antihistamine that’s used to treat allergic reactions , but it also works to decrease activity in the brain. Both hydroxyzine and the types of beta blockers prescribed for anxiety act quickly, like benzodiazepines, but unlike benzodiazepines, they don’t cause dependence.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291273b28a-ed0f-4dbb-94cf-843d331c80cde60dc2a1-f33c-4a05-9b50-8e3e8e597629571288d1-5ca3-47cb-9842-ae41b8438676
Benzodiazepines Which Benzodiazepines Are Used for Anxiety? Benzodiazepines help relieve anxiety by enhancing the activity of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain and generating a sedative effect. They work quickly, and most work to relieve anxiety for several hours.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ea398676-124e-4b1a-a72b-d47115ebadfc They are usually prescribed for those with generalized anxiety disorder , panic disorder , and social anxiety disorder .e60dc2a1-f33c-4a05-9b50-8e3e8e5976290a82c118-bdb9-47b1-960a-3056e4689daf Because they work so quickly, and because people taking them can build up a tolerance that leaves them needing higher doses to feel better, doctors will prescribe them for very short periods of time — usually no more than a month.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298e763b78-8f50-47f7-86b3-0c878b0c0b96 Unfortunately, people can become dependent on benzodiazepines, even in a short period of time. If you stop taking them suddenly, withdrawal symptoms may occur, so it’s important to follow your doctor’s instructions for tapering off your medication.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299b3c590c-0c04-45e8-abae-29c2a1ec200e They can also initially be used with antidepressants, while you wait for the antidepressants to work.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a3cb3cc7-13cd-4948-bc0b-f81387435052 “They’re a powerful tool,” says Duckworth, “but you have to be really smart about their use.” Commonly prescribed benzodiazepines include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976299920c3a6-7455-4bce-9579-23bee49f776a alprazolam (Xanax) clonazepam (Klonopin) lorazepam (Ativan) diazepam (Valium) chlordiazepoxide temazepam (Restoril) triazolam (Halcion) Side effects of benzodiazepines may include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629dc7af7aa-4ecf-4991-984c-762a231cd48a Trouble breathing Drowsiness Tiredness or fatigue Slowed heart rate Low blood pressure Fainting
The Takeaway While different anxiety disorders have different symptoms, treatment plans for each type often include a combination of psychotherapy and medication. Antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and norepinephrine-dopamine reuptake inhibitors (NDRIs), are often the first treatment a doctor will prescribe for an anxiety disorder. Benzodiazepines, fast-acting medications that work to enhance the action of a calming chemical in the brain, are typically only offered in the short-term on an as-needed basis, because they can cause dependence, tolerance, and withdrawal. Other medications, including buspirone, antihistamines, and certain heart medications called beta blockers, can also be prescribed to treat anxiety disorders. Additional reporting by Carlene Bauer .
Resources We Trust Mayo Clinic: Anxiety Disorders: Diagnosis and TreatmentCleveland Clinic: Anxiety DisordersNYU Langone Health: Medication for Anxiety DisordersUniversity of Florida Health: Generalized Anxiety Disorder — Self-CareNational Institute of Mental Health: Mental Health Medications