Medication for Anxiety: A Complete Guide

As you probably know from personal experience, anxiety can be a lot of things — a cause of insomnia, a demon you have to fight to accomplish your most intimidating goals, or a roadblock to living your best life.

Unfortunately, anxiety isn’t just something you can turn off when it’s inconvenient. Most people living with it require external help in the form of therapy, lifestyle changes, and/or medication.

For some, cutting back on caffeine, spending more time in nature, and listening to a meditation app may be enough to shift the balance of power and get through the day mostly unscathed by anxiety. Others require anti-anxiety meds, which are a safe and effective option for managing this condition.

If you’re curious about anxiety medications, including how they work, side effects, and popular options, you’ve come to the right place.

Anxiety disorders are very common. An estimated 31.1 percent of American adults will experience some form of anxiety disorder during their lives, and many of those people find help from one of the tested, proven medications for anxiety on the market right now.

Anxiety medications go by a few names and are sometimes called anxiolytics or anti-anxiety drugs. Some anxiety medications are even technically in other medication categories, like antidepressants. 

Types of anxiety pills include:

• Antidepressants

• Benzodiazepines

• Beta-blockers

• Other medications, like buspirone

Each type works in a slightly different way to reduce the severity of anxiety symptoms and help you enjoy a less stressful daily life.

Medications don’t “cure” anxiety. For them to keep working, you have to continue taking them. And for optimal improvement, it’s important to pair them with lifestyle habits and other support, which we’ll cover later. 

However, anxiety meds can reduce (or even eliminate) the symptoms of anxiety that prevent you from asking that cute person out, pivoting into a new career path, or simply leaving your house to run errands.

And on that note, a reminder that everyone’s struggles are unique. That means treatment options are, too. It’s common to require some trial and error when choosing the right anxiety medication for you — luckily, there are a lot of options. 

First, read on to understand how each class of medication helps to reduce your symptoms of anxiety.

Believe it or not, some of the most common medications for anxiety are medications that were originally developed for another type of mental health condition — depression. 

Certain antidepressants are prescribed to treat anxiety because they target the neurotransmitters (brain chemicals) responsible for the feelings and symptoms that characterize anxiety disorders. 

Most antidepressant medications take several weeks to start working, so they’re not used for immediate relief from panic attacks (although they do effectively treat the underlying panic disorder - it just takes a few weeks) or other short-term anxiety symptoms. However, because of their overall safety profile, antidepressants are generally used for long-term treatment and to manage chronic anxiety. 

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors, or SSRIs, are one of the most commonly prescribed types of antidepressants and are often used to treat anxiety disorders. 

Serotonin is a neurotransmitter responsible for regulating important things like your mood, ability to relax, appetite, and ability to sleep. 

Experts believe that people living with anxiety and depression have altered levels of serotonin, so getting it back on track appears to be helpful.

SSRIs, which first came onto the market in the 1980s, work by blocking the reabsorption of serotonin into your brain. This increases your levels of available serotonin and can lessen anxiety symptoms.

SSRIs are not considered addictive and can’t be abused (unlike benzodiazepines). However, they do have a variety of potential side effects that you should be aware of before using them for an anxiety disorder. Some of the most notable side effects are sexual side effects, gastrointestinal issues, and weight gain.

List of SSRIs Used to Treat Anxiety

In the United States, several SSRIs are prescribed to treat anxiety disorders, including:

• Sertraline

• Escitalopram

• Paroxetine

• Fluoxetine

• Fluvoxamine

• Citalopram

Here’s how they compare.

Other Common Antidepressants for Anxiety 

In addition to SSRIs, several other types of antidepressants are commonly prescribed to treat anxiety:

• Serotonin-norepinephrine reuptake inhibitors (SNRIs)

• Monoamine oxidase inhibitors (MAOIs) 

• Tricyclic antidepressants (TCAs) 

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

As the name suggests, SNRIs work similarly to SSRIs, with one key change (yes, the one letter). In addition to increasing the amount of serotonin in your brain, they also increase the level of norepinephrine — a neurotransmitter responsible for regulating alertness, attention, memory, and other mental and physical functions.

SNRIs used to treat anxiety include:

• Duloxetine. Sold as Cymbalta®, duloxetine is an SNRI used to treat generalized anxiety disorder. Our guide to duloxetine (Cymbalta) for anxiety provides more information on how this medication works, its side effects, and more. 

• Venlafaxine. Sold under the brand name Effexor®, venlafaxine is used to treat social anxiety disorder, panic disorder, and generalized anxiety disorder.

Monoamine Oxidase Inhibitors (MAOIs)

Monoamine oxidase inhibitors (MAOIs) are older antidepressants, first discovered in the 1950s by clinical researchers. While they aren’t used often for mental health treatment nowadays, some MAOIs may be effective as a treatment for anxiety conditions such as social anxiety disorder and panic disorder. 

Like other antidepressants, MAOIs work by boosting your brain’s level of serotonin, norepinephrine, and dopamine. While they’re effective, they’re more likely to cause side effects and drug interactions than newer antidepressants used for anxiety.

The FDA has not approved most MAOIs to treat anxiety. However, your healthcare provider may prescribe them off-label if other treatments aren’t effective. 

MAOI antidepressants that may be used to treat anxiety disorders include phenelzine, selegiline, and tranylcypromine. 

If your healthcare provider prescribes you an MAOI, they may tell you to carefully monitor your use of other medications. 

Additionally, you should avoid foods and beverages with high levels of tyramine (an amino acid that regulates blood pressure) when taking an MAOI because they can cause a potentially dangerous spike in blood pressure. This includes many cheeses, fermented foods, and citrus fruits, among other foods.

Tricyclic Antidepressants (TCAs)

Some tricyclic antidepressants (TCAs) are used to treat anxiety disorders. Tricyclics are also an older class of antidepressants developed in the 1950s. 

They work by increasing the levels of mood-related neurotransmitters in your brain and include: 

• Clomipramine

• Doxepin

• Imipramine

Like MAOIs, tricyclic antidepressants typically have a higher risk of side effects than the more modern SSRI and SNRI medications. 

Because of this, they’re rarely used as first-line treatments for anxiety. So if your healthcare provider prescribes one of these, it’s likely because the SSRIs and SNRIs didn’t work for you.

These are just some of the many antidepressants on the market today that can be used to treat anxiety. Check out our complete list to learn more.

Benzodiazepines are some of the most widely used medications in the United States, with tens of millions of users nationwide, including many older people. 

They’re a class of medications used to treat anxiety disorders, and some are also prescribed as sleeping pills for the short-term treatment and management of insomnia.

Benzodiazepines reduce anxiety, relax muscles, and promote sedation. Over the long term, benzodiazepine use can lead to dependence and abuse. 

If you use them for longer periods of time, they can be very difficult to stop because of severe withdrawal symptoms. Paradoxically, they can make anxiety worse if they’re taken for too long. Some doctors feel that the long-term risks are so significant that they outweigh the potential benefits.

The good news is that they can be helpful in the short term. Benzodiazepines typically start working very quickly — their anti-anxiety effects may start in less than an hour. 

They work so well that many people don’t want to stop taking them, which is another reason they can be dangerous.

Benzodiazepines increase the effects of a neurotransmitter called gamma-aminobutyric acid, or GABA. GABA is an inhibitory neurotransmitter, so it decreases activity in the neurons to which it binds. This can cause you to feel less anxious, stressed, or fearful.

GABA is also thought to regulate emotion, memory, thinking, and certain essential biological functions. By increasing the effects of GABA, benzodiazepines essentially slow down specific brain activity to reduce feelings of anxiety and stress. 

List of Benzodiazepines for Anxiety

Common benzodiazepines for anxiety include:

• Alprazolam

• Chlordiazepoxide

• Clonazepam

• Clorazepate

• Diazepam

• Estazolam

• Flurazepam

• Lorazepam

• Oxazepam

Other benzodiazepines, such as temazepam and triazolam (available as Halcion®), are used as sleep aids and aren’t widely prescribed for anxiety. 

Here’s how these meds compare (note that Hers does not offer any benzodiazepines as part of our medication program). 

Benzodiazepine Side Effects

Benzodiazepines can cause side effects, including some that may affect your alertness, physical health, and daily life.

Common side effects of benzodiazepines include:

• Drowsiness

• Confusion

• Headache

• Upset stomach

• Vomiting

• Diarrhea

• Tremors

In some cases, benzodiazepines may cause breathing issues, including respiratory depression (failure of the lungs to exchange carbon dioxide and oxygen properly).

When taken in the evening, particularly when used to treat anxiety-related insomnia, it’s common for some benzodiazepines to cause a next-morning “hangover” effect. 

Most benzodiazepines are only recommended for short-term use. When used for the long term, treatment with benzodiazepines can lead to dependence, addiction, and abuse. This is why it’s imperative to follow your provider’s instructions. 

These anti-anxiety medications can also cause withdrawal symptoms if you stop them suddenly, especially if you’ve been taking one at a high dose for a while.

If you’re prescribed any type of benzodiazepine, do not abruptly stop taking it without first talking to your healthcare provider. They will tell you how to reduce your dosage to zero while avoiding withdrawal syndrome.

Beta blockers are a class of medications used to reduce blood pressure. They’re often prescribed to manage heart conditions, such as angina (chest pain), irregular heartbeat, and heart failure, or to improve heart function in people who’ve recently had a heart attack.

Certain beta blockers are also effective at treating physical symptoms of anxiety disorders, such as tremors, excessive sweating, and rapid heart rate.

Although they aren’t FDA-approved for anxiety, your healthcare provider may prescribe a beta blocker off-label if you’re affected by anxiety in stressful situations. 

Beta blockers block the effects of epinephrine, or adrenaline, a hormone that controls your fight-or-flight response. This slows your heartbeat and improves your circulation.

Beta blockers may be especially helpful for treating symptoms of performance anxiety, a form of anxiety related to speaking or performing in front of an audience. 

Like benzodiazepines, beta blockers start working quickly to treat physical symptoms of anxiety. For example, propranolol, a widely used beta blocker, usually starts working less than one hour after it’s taken.

One thing to note about beta blockers is that they only treat the physical effects of anxiety, not the psychological symptoms. 

However, if you’re standing in front of an audience and the medication keeps your heart rate steady and prevents you from trembling and sweating, you’ll probably feel more confident.

As such, beta blockers are usually prescribed to treat moderate or severe anxiety that only occurs in certain situations. 

Using Beta-Blockers to Treat Anxiety

Beta blockers used to treat anxiety include:

• Propranolol. Propranolol is a common, widely prescribed beta blocker that’s often used off-label to treat physical symptoms of performance anxiety. Our detailed guide to propranolol explains how it works, its adverse effects, and more.

• Atenolol. Atenolol is a slightly longer-acting beta blocker. Although it’s not FDA-approved to treat anxiety, it’s occasionally used off-label to treat physical symptoms associated with performance anxiety.

Like other prescription medications, beta blockers may cause side effects. Common side effects of beta blockers include:

• Fatigue

• Dizziness

• Nausea

• Constipation

• Bradycardia (slow heart rate)

• Hypotension (low blood pressure)

It’s a good idea to take a test dose of the medication before using it to help you with a speech or performance. Although the dosage for anxiety is lower than the dosage used to treat high blood pressure, some people experience a marked drop in their blood pressure and may find it difficult to stand up without fainting.

Beta blockers can also interfere with some other medications, including medication for heart disease and other conditions. 

To avoid these side effects and medication interactions, discuss your general health and use of other medications with your healthcare provider before using a beta blocker to treat anxiety. 

Most cases of anxiety that require medications can be treated using benzodiazepines, antidepressants, or beta blockers, along with behavioral therapy. However, several other types of medication are also used to treat anxiety.

One is Seroquel®, an antipsychotic, which is used off-label. Learn more about the pros and cons of Seroquel for anxiety and depression.

Other categories of medications for anxiety include: 

• Antihistamines. Ever used Benadryl® to calm down? Some antihistamines have a calming effect, making them an effective option for mild to moderate anxiety. They can also help to promote sleep — a common difficulty for people with anxiety. Hydroxyzine, sold under the brand name Vistaril®, is occasionally used as a short-term treatment for anxiety.

• Anticonvulsants. Anticonvulsant medications, such as gabapentin and pregabalin, may help treat symptoms of some anxiety disorders, such as generalized anxiety disorder and social anxiety disorder. In many states, gabapentin and pregabalin are controlled substances because they can be habit-forming, so it's best to try other options first.

• Buspirone. Buspirone is an azapirone medication that’s used to treat certain anxiety disorders, though it does have some limitations. Like SSRIs, buspirone may take several weeks of treatment to produce a noticeable improvement in the symptoms of anxiety.

One of the worst things about anxiety is the recurring feeling of being overwhelmed. The irony is not lost on us that you just read a long and potentially overwhelming article about anxiety medications. 

Here’s the bottom line: There are plenty of effective anxiety medications to choose from, and we can’t say for sure which may be right for you, but there’s a good chance one will be. Our struggles are personal. Therefore, our treatment options need to be, too. 

Whether that turns out to be antidepressants, benzodiazepines, or beta blockers, your healthcare provider will help you determine the best option.

When pursuing anxiety treatment, stay focused on what matters:

• There’s no one-size-fits-all. Finding the best anti-anxiety medication for you may take some trial and error, and it may not be the same one that works for your friend. Both are okay. 

• Follow your provider’s instructions closely. Stick to your dosage and be aware of potential side effects. Talk to your provider before making any changes to your routine or if you’re experiencing adverse effects, like weight gain, that concern you.

• Other habits help, too. Psychotherapy and lifestyle changes can often help treat anxiety whether or not you’re taking medication. Meditation and self-care techniques can be practiced at home. Find out more in our guides to calming down anxiety on your own and natural remedies for dealing with anxiety symptoms.

Hers’ mental health services are a great place to start if you want someone to provide personalized guidance.

We offer a range of mental health treatments online and medication for anxiety or depression. Our online psychiatry is a great option for people who want something more convenient than traveling to an office.

There are so many options that choosing can seem daunting. Make the only right choice — ask for help today.