Anti-Anxiety Medications: A Complete Guide

Anti-Anxiety Medications: A Complete Guide

Feeling anxious, especially before a big event or stressful situation, is a normal part of life. For people with anxiety disorders, however, anxiety can be a nonstop problem that has a negative effect on everything from work to relationships.

Anxiety disorders are extremely common -- in fact, they’re the most common mental illness in the United States. According to the Anxiety and Depression Association of America, more than 18 percent of all American adults are affected by an anxiety disorder each year.

Dealing with an anxiety disorder can be a frustrating experience. Luckily, anxiety disorders are treatable, with a variety of options available to relieve the symptoms of anxiety and make living a normal life easier.

While anxiety is commonly treated using psychotherapy, treatment for anxiety can also involve the use of medication.

Below, we’ve listed the medications that are typically prescribed for anxiety. We’ve also talked about how each medication works, its safety, as well as the side effects you may experience if you’re prescribed a certain medication to treat an anxiety disorder.

Anti-Anxiety Medications: The Basics

  • There are several different anxiety disorders, each with different symptoms. As such, there’s no one-size-fits-all medication that treats anxiety perfectly for everyone. If you have anxiety, your healthcare provider will choose a medication that’s right for you.
  • Numerous different types of medication are used to treat anxiety disorders, including benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), beta blockers and several others.
  • Medication doesn’t cure anxiety. Instead, anti-anxiety medications provide relief from the symptoms of anxiety, allowing you to focus on living a normal life.
  • While anti-anxiety medications are safe for most people, some can cause dependence and withdrawal symptoms when used over a long period of time or abused.
  • If you have an anxiety disorder, medication alone may not be enough to help you bring your symptoms under control. For better results, your healthcare provider may suggest psychotherapy or encourage you to make certain changes to your lifestyle. 

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors, or SSRIs, are a class of antidepressants. In addition to treating depression, some SSRIs are also commonly used to provide relief from the symptoms of anxiety.

SSRIs offer a number of benefits over benzodiazepines. Of these, the biggest is that they have a significantly lower risk of dependency and abuse.

Common SSRIs used to treat anxiety include citalopram (sold under the brand name Celexa®), Fluvoxamine (Luvox®), fluoxetine (Prozac®), sertraline (Zoloft®), escitalopram (Lexapro®) and paroxetine (Paxil®).

Unlike benzodiazepines, SSRIs don’t start treating anxiety immediately. Instead, you’ll typically need to use this kind of medication for four to six weeks before you notice any improvement in your symptoms. 

Used appropriately, many SSRIs can reduce the severity of anxiety symptoms and make it easier to live with an anxiety disorder.

SSRI Side Effects and Safety

Like other medications used to treat anxiety, SSRIs do have certain downsides. The first is that they can often cause side effects, ranging from mild to severe. The second is that they can, for some people, cause physical dependence and withdrawal symptoms.

Side effects are quite common with antidepressants. While SSRIs have a lower risk of causing side effects than many older antidepressants, some people who use SSRIs will experience side effects after starting treatment. Common side effects of SSRIs include:

  • Agitation
  • Nausea and vomiting
  • Dizziness
  • Diarrhea
  • Insomnia
  • Reduced sex drive
  • Difficulty reaching orgasm
  • Weight gain
  • Blurred vision
  • Headaches
  • Increased sweating

We’ve provided more information about the sexual side effects listed above in our full guide to antidepressants and sexual side effects.

Your risk of experiencing side effects can vary based on a range of factors, including the specific type of SSRI you’re prescribed. For example, some SSRIs, such as paroxetine (Paxil), are more likely to cause sexual side effects than others.

Many side effects from SSRIs develop during the first few weeks of treatment. If you experience persistent side effects after using an SSRI for several months, it’s best to talk to your healthcare provider. They may be able to suggest a different medication that’s better suited to you.

While SSRIs generally aren’t as likely to cause dependence as benzodiazepines, some people may experience withdrawal symptoms if they stop using SSRIs suddenly. This is referred to as antidepressant discontinuation syndrome. 

Antidepressant discontinuation syndrome affects approximately 20 percent of people who stop using antidepressants abruptly. If you suddenly stop taking an SSRI, you may experience the following symptoms, typically over the course of several weeks:

  • Flu-like symptoms
  • Insomnia
  • Nausea
  • Imbalance
  • Sensory disturbances
  • Hyperarousal

To avoid antidepressant discontinuation syndrome, it’s important that you talk to your healthcare provider before making any changes to your use of SSRIs.

Finally, SSRIs and other types of antidepressants may potentially contribute to an increased risk of suicidal thousands and/or behavior in people under the age of 24. We’ve explained this issue in more detail in our comprehensive guide to SSRIs

Beta Blockers

Beta blockers are a type of cardiac medication. They work by making your heart slow down and work with a lower force of contraction, resulting in a slower heartbeat and reduced level of blood pressure.

More specifically, beta blockers block the effects of the hormone norepinephrine, which plays a key role in your body’s response to stressful events.

Most of the time, beta blockers are prescribed to people with cardiovascular health issues, such as people with hypertension (high blood pressure), heart failure or people who’ve recently had a heart attack.

Although beta blockers aren’t formally approved by the FDA for treating anxiety disorders, some healthcare professionals may prescribe beta blockers off-label to treat the physical symptoms of certain anxiety disorders.

Common beta blockers used off-label to treat physical symptoms of anxiety include propranolol (Inderal®) and atenolol (Tenormin®).

Beta blockers won’t affect your brain in the way that benzodiazepines or SSRIs do. This means that you won’t feel any different emotionally after using them if you’re prescribed a beta-blocker for anxiety.

However, they can help to control the physical symptoms of anxiety, such as a racing heartbeat, shaking hands, shortness of breath, sweating, changes in your voice and other physical signs of anxiety or nervousness.

Because of this, beta blockers typically aren’t prescribed for anxiety disorders that affect you all the time, such as generalized anxiety disorder. Instead, they’re prescribed for use as needed to treat certain phobias, such as anxiety related to meeting new people or performing in public.

Beta-Blocker Side Effects

Beta blockers are generally safe medications for most people. Because they’re used only as needed to treat anxiety, they aren’t addictive or habit-forming in the way that other anti-anxiety medications often are. 

However, some people experience side effects while using beta blockers to treat anxiety. Side effects of beta blockers include:

  • Shortness of breath
  • Difficulty breathing
  • Coldness or tingling that affects the hands and feet
  • Drowsiness and/or fatigue
  • Reduced sex drive
  • Mild depression
  • Nausea, constipation or diarrhea
  • Difficulty sleeping and/or disturbing dreams
  • Weight gain

Side effects can vary from one beta blocker medication to another. Typically, people who use a beta blocker at a lower dose have a reduced risk of experiencing noticeable side effects. When side effects occur, switching to another beta blocker may be helpful.

Buspirone

Buspirone is a relatively modern anti-anxiety medication that was first approved by the FDA in 1986. It’s often viewed as a preferable treatment for anxiety, as it’s less likely to cause certain side effects than other medications.

Historically, buspirone has been sold under the brand name BuSpar. Today, it’s available as a generic medication under a variety of brand names. 

Unlike benzodiazepines, buspirone isn’t an addictive medication. There’s no associated risk of physical dependence among people who use buspirone, nor is there evidence that it can cause withdrawal symptoms if treatment is suddenly stopped.

Because of its relative safety and low risk of dependence, buspirone is often prescribed as an anti-anxiety medication for people who’ve previously experienced issues related to substance abuse.

It usually takes two to four weeks for buspirone to start working as a treatment for certain forms of anxiety, such as generalized anxiety disorder. 

Buspirone is generally used as a second-line treatment for certain anxiety disorders in people who don't respond well to other medications, such as benzodiazepines or SSRIs. It may also be used alongside SSRIs in people with anxiety who experience sexual side effects. 

Although buspirone offers a number of advantages over other anti-anxiety medications, it has certain limitations. For example, although it’s usually effective for generalized anxiety disorder, it’s significantly less effective for many other anxiety disorders.

Buspirone Side Effects

Like other anti-anxiety medications, buspirone can cause side effects. Potential side effects of buspirone include:

  • Dizziness
  • Confusion
  • Nausea
  • Lightheadedness
  • Sweating
  • Numbness
  • Headache
  • Fatigue
  • Feelings of anger or hostility
  • Diarrhea
  • Insomnia, or difficulty staying awake
  • Excitement
  • Weakness

Of these side effects, dizziness is the most common, affecting more than 10 percent of people who use buspirone. Like many other medications, the side effects of buspirone may gradually disappear over the course of several weeks or months of treatment.

Benzodiazepines

Benzodiazepines are a class of medications that are commonly prescribed to treat anxiety, as well as related conditions such as insomnia and agitation. 

Right now, benzodiazepines are the most widely prescribed anti-anxiety medications. They’re designed to work quickly and provide relief from anxiety symptoms in about 30 minutes to one hour after they’re taken.

Benzodiazepines that are used to treat anxiety include alprazolam (sold under the brand name Xanax®), diazepam (Valium®), clonazepam (Klonopin®) and lorazepam (Ativan®). 

Because benzodiazepines work quickly, they’re useful for treating acute anxiety. People with a panic disorder, for example, often use benzodiazepines to provide relief from their symptoms in situations that may cause them to panic. 

Benzodiazepines slow down the workings of your central nervous system by changing the way certain receptors, referred to as GABA receptors, function. These receptors are responsible for managing your body’s response to certain neurotransmitters that control brain function.

This effect makes it easier for you to feel relaxed, both mentally and physically. If you have an anxiety disorder, using a benzodiazepine may make you feel calm and significantly lower your risk of panicking. 

While effective, benzodiazepines have several downsides. The first is that they tend to become less effective over time as the body adjusts to their effects. For some people, it only takes a few weeks for benzodiazepines to become less effective at treating anxiety.

The second is that benzodiazepines can cause withdrawal symptoms and side effects. You can read more about these side effects and symptoms, as well as other potential safety issues that are associated with benzodiazepines, in the section below. 

Benzodiazepine Side Effects and Safety

Although benzodiazepines are generally safe when used over the short term, long-term use of most benzodiazepines is generally discouraged by experts due to the risk of abuse. 

As we mentioned above, benzodiazepines can become less effective as your body develops a tolerance. This means that you may need to constantly increase your dose over time to get the same effects from the medication.

Because of this, it’s surprisingly easy for people to go from using benzodiazepines responsibly, carefully and exactly as prescribed to abusing their medication as they develop a tolerance.

Benzodiazepines also have several other safety risks. While they’re usually effective at treating anxiety, they can also cause a range of side effects, such as:

  • Drowsiness
  • Fatigue
  • Lethargy

At higher doses, such as those that may be used by people with dependence, benzodiazepines can also cause:

  • Impaired motor coordination
  • Dizziness
  • Mood swings
  • Vertigo
  • Impaired thinking
  • Blurry vision
  • Confusion
  • Slurred speech
  • Hostile or erratic behavior in some people
  • Euphoria

These side effects may interfere with regular life, potentially causing danger if you need to drive, work with machinery or spend time in other potentially hazardous situations.

People who use benzodiazepines frequently may also experience withdrawal symptoms if they suddenly stop. These can include worsened anxiety, insomnia, depression and other physical symptoms, such as sweating, a pounding heartbeat, shaking and stomach pain.

Withdrawal from many benzodiazepines can also cause serious, potentially harmful symptoms, such as seizures.

Finally, benzodiazepines can interact with alcohol and certain other medications. For example, benzodiazepines should never be used with alcohol, sleeping pills or painkillers due to the risk of fatal overdose.

Some other medications, such as antihistamines and antidepressants, may also amplify some of the effects of benzodiazepines or increase their concentration within your body.

Due to these side effects and safety risks, it’s important to only use benzodiazepines exactly as prescribed. If you’re prescribed this type of medication, talk to your healthcare provider to make sure that you’re fully informed about how to use your medication safely. 

Other Ways to Relieve Anxiety

Although medication can make a huge difference if you have an anxiety disorder, you may also be able to relieve anxiety by making certain changes to your habits and lifestyle. There are also some natural products that may provide relief from anxiety symptoms.

If you believe that you have an anxiety disorder, your first priority should be to talk to a licensed psychiatry provider about proven, science-backed medications and therapy.

In addition to using medication and psychotherapy, you can try the following habits and lifestyle changes:

  • Learn your anxiety triggers. If certain things trigger your anxiety, try to make a note of them. This way, you’ll find it easier to identify situations that might make you feel anxious and take steps to keep yourself calm in the future.
  • Stay physically active. Research shows that exercise reduces overall levels of stress and helps to maintain a stable mood. Better yet, these effects happen relatively quickly, with just five minutes of exercise enough to start to produce an anti-anxiety effect.

    If you’re not currently physically active, set a goal of trying to reach the two-and-a-half hours of moderate-intensity exercise (for example, brisk walking) recommended by the Department of Health and Human Services.
  • Limit your caffeine and alcohol consumption. Caffeine and alcohol can both worsen anxiety symptoms and trigger panic attacks. Try to limit your caffeine consumption to as little as possible, and be responsible when you drink anything containing alcohol.
  • When necessary, use coping strategies. Simple things like counting to 10 or taking a series of deep breaths can have a surprisingly large impact on the way you feel if you’re prone to anxiety. You can find a list of coping strategies on the ADAA website

Other techniques, such as meditation, can also help you to relax and overcome anxiety when it flares up. You can learn more about this and other techniques for dealing with the symptoms of anxiety disorders in our full guide to coping with anxiety

In Conclusion

Anxiety disorders are extremely common. Luckily, multiple medications are available to provide relief from anxiety symptoms. Many of these medications are effective on their own and can be even more effective if used in combination with therapy and changes to your lifestyle. 

There’s no “best” anti-anxiety medication for every person and anxiety disorder. If you think that you have an anxiety disorder, your healthcare provider will work alongside you to recommend a medication that’s best suited to your symptoms, needs and general health.

If you’re prescribed any type of anti-anxiety medication, use it exactly as prescribed and stay in touch with your healthcare provider to keep them informed about your treatment.  

Get Help for Anxiety Online

Dealing with anxiety can be a frustrating, difficult experience. Luckily, help is always available. If you think you may have an anxiety disorder and need help, you can talk to a licensed psychiatry provider online and start receiving personalized treatment based on your needs. 

Based on your evaluation, you may receive evidence-backed medication to help you treat your anxiety symptoms. From your smartphone, you’ll work with your psychiatry provider in personal, ongoing follow-ups to evaluate your treatment and track your progress. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.