What are the four main types of anti-anxiety medications?
Several types of medication can treat the symptoms of anxiety. The Anxiety and Depression Association of America (ADAA) notes there are of drugs for anxiety disorders.
Serotonin reuptake inhibitors (SSRIs)
Although SSRIs are a type of antidepressant, doctors can prescribe them to people with anxiety and obsessive-compulsive disorder (OCD).
According to a 2022 article, doctors consider SSRIs to be the first-line drug treatment for generalized anxiety disorder.
SSRIs stop nerve cells in the brain from reabsorbing serotonin, a chemical that plays a vital role in mood regulation.
Examples of SSRIs for anxiety include:
citalopram (Celexa)
escitalopram (Lexapro)
fluoxetine (Prozac)
fluvoxamine (Luvox)
paroxetine (Paxil, Pexeva)
sertraline (Zoloft)
These medications typically begin to take effect within 2 to 6 weeksTrusted Source, but they may not work for everyone. People usually take SSRIs for 6 to 12 months to treat anxiety and then gradually reduce the dosage.
These drugs are not habit-forming, meaning that they do not usually lead to dependence.
People should consult a doctor or physician before they start reducing or stopping their medication.
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
SNRIs are another class of antidepressants that can treat depression and anxiety. Doctors may also prescribe them to treat some chronic pain conditions.
The ADAA notes that medical professionals also consider SNRIs to be the first-line treatment for anxiety. However, they are not as effective in treating OCD.
These medications work by reducing the brain’s reabsorption of the chemicals serotonin and norepinephrine.
Examples of SNRIs for anxiety are:
duloxetine (Cymbalta)
venlafaxine (Effexor XR)
As with SSRIs, SNRIs can take several weeks to have an effect.
»Discover:The differences between SSRIs and SNRIs
Tricyclic antidepressants (TCAs)
TCAs are an older class of antidepressant. Although they may be effective for the treatment of depression and anxiety, doctors often prescribe SSRIs instead as they cause fewerTrusted Source adverse side effects.
However, TCAs may be useful for some people, especially if other medications do not provide relief.
These medications work by blocking the reabsorption of serotonin and norepinephrine. This increases the levels of these neurotransmitters in the brain.
Examples of TCAs for anxiety include:
amitriptyline (Elavil)
imipramine (Tofranil)
nortriptyline (Pamelor)
Benzodiazepines
Boxed warnings: Increased risk of death in certain older adults
Fanapt has a boxed warning about an increased risk of death in certain older adults. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
Older adults with dementia-related psychosis who take atypical antipsychotic drugs have an increased risk of death. For this reason, Fanapt is not approved for psychosis that’s related to dementia in adults ages 65 years and older.
For more information, see “Dosage adjustments” in the “Factors that can affect your dosage” section below.
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Benzodiazepines are a type of sedative that reduces the physical symptoms of anxiety, such as tense muscles. These drugs also encourage relaxation, and their effects take place quickly.
Peak levels in the blood occur 1 to 2 hours after a person takes their dose. People may feel the effects sooner than this.
Benzodiazepines include:
alprazolam (Xanax)
chlordiazepoxide (Librium)
diazepam (Valium)
lorazepam (Ativan)
Although they can be highly effective for short-term issues, doctors rarely prescribe benzodiazepines because they become less effective over time and can be addictive.
Due to these risks, experts suggest that doctors do not prescribe the continuous use of benzodiazepines for more than 6 monthsTrusted Source.
Some people may take benzodiazepines to manage short-term anxiety. For example, people with a fear of flying may take them before a flight.
At times, people can take a benzodiazepine alongside an SSRI for 2 to 4 weeks until the SSRI takes effect.
Other medications for anxiety
Many other medications may help treat anxiety, although doctors usually only prescribe them if SSRIs or similar drugs do not work.
Beta-blockers
Beta-blockers are a common medication for people with high blood pressure and heart conditions. However, doctors may prescribe themTrusted Source off-label for anxiety in certain situations.
Beta-blockers reduce the effects of norepinephrine, meaning that they can relieve some of the physical symptoms of anxiety. Examples of beta-blockers include atenolol (Tenormin) and propranolol (Inderal).
Buspirone
This anti-anxiety medication may treatTrusted Source short- or long-term anxiety symptoms.
Buspirone (BuSpar) works much more slowly than benzodiazepines and may not treat all types of anxiety disorders, but it causes fewer side effects and has a lower risk of dependency.
Monoamine oxidase inhibitors (MAOIs)
MAOIs are one of the earliest types of antidepressant. Doctors may prescribe them off-label to treat some types of anxiety, though they can potentially cause serious side effects, so doctors rarely prescribe them.
Types of MAOI include:
isocarboxazid (Marplan)
phenelzine (Nardil)
selegiline (Emsam)
tranylcypromine (Parnate)
Side effects
Antidepressants and other drugs for anxiety have the potential to cause side effects in some people. These often resolve after a few weeks, but it is crucial to contact a doctor if they are severe or do not subside.
Some doctors may recommend taking anxiety medications with food to minimize side effects or taking them before bed if the drug does not interfere with sleep.
The side effects a person experiences may vary depending on the type of medication.
SSRIs
The side effects of SSRIs can include:
nausea
diarrhea
constipation
loss of appetite
blurry vision
dizziness
drowsiness or fatigue
dry mouth
feeling agitated or restless
headaches
sexual difficulties or erectile dysfunction
sleep problems
SNRIs
The side effects of SNRIs are similar to those of SSRIs, and can include:
constipation
dizziness
drowsiness or fatigue
dry mouth
headaches
increased blood pressure
loss of appetite
nausea
sexual problems or erectile dysfunction
sleep problems
sweating more than usual
stomach aches
TCAs
Side effects vary among TCAs as they work in different ways. Possible side effects include:
blurry vision
constipation
difficulty urinating
dry mouth
drowsiness
increase in appetite
lightheadedness
low blood pressure after standing up
sexual problems or erectile dysfunction
sweating more than usual
tremors
weight gain
Benzodiazepines
Benzodiazepines can cause several side effects, such as:
blurry vision
confusion
dizziness
drowsiness or fatigue
headaches
loss of memory or concentration
issues with balance, coordination, or speech
an upset stomach
Benzodiazepines also carry certain risks. For example, they can cause physical dependence, even after a short period of use. Withdrawal from benzodiazepines may lead toTrusted Source:
anxiety and restlessness
depression
sleep problems
sweating
seizures
More severe risks of benzodiazepines may includeTrusted Source:
addiction
cognitive decline
fractures
motor vehicle accidents as benzodiazepines can affectTrusted Source a person’s ability to drive
overdose, especially in combination with opioid drugs or alcohol
Beta-blockers
Possible side effects of beta-blockers include:
cold hands and feet
depression
tiredness
low blood pressure
shortness of breath
sleep issues
sexual problems
People with asthma should avoid beta-blockers. Individuals with diabetes should take them with caution and speak with a doctor about the possible risks.
Buspirone
The side effects of buspirone may include:
blurry vision
diarrhea
dizziness
drowsiness
dry mouth
fatigue
headaches
muscle pains
nausea
confusion
restlessness or nervousness
sleep problems
sweating
weakness
MAOIs
Some common side effectsTrusted Source of MAOIs include:
nausea
diarrhea
constipation
dry mouth
dizziness
drowsiness
lightheadedness
insomnia
These medications also interact with several other drugs, as well as some foods and drinks. Anyone taking MAOIs should ask their doctor for a complete list of the medications, foods, and drinks they need to avoid.
Suicide risk and antidepressants
In 2004, the FDA requiredTrusted Source all antidepressants to carry a black-boxed warning relating to the risk of suicide in children and young adults.
People under 25 years of age may experience an increase in suicidal thoughts and behaviors while taking antidepressants.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support
If you’re not in the same household, stay on the phone with them until help arrives.
Home remedies for anxiety
A person may wish to try the following remedies to help treat anxiety:
breathing exercises
meditation
physical exercise
yoga
acupuncture
Some people may experience relief from anxiety through hobbies, such as painting or playing music.
There is also evidence to suggest that spending time with pets may be beneficialTrusted Source to people with a variety of mental health issues, including anxiety.
Alternative treatments
A common type of therapy for anxiety is cognitive behavioral therapy (CBT). This helps people to change their thoughts and behaviors by analyzing what may be causing them anxiety. CBT appears to be an effective form of therapy for treating anxiety disorders.
There are many other approaches to therapy, and what is right for one person may not work for someone else. People may wish to try a variety until they find what works for them.
Mental health support
There are many resources for people experiencing anxiety.
The first point of contact for people not in crisis should be a mental health professional or their primary care doctor. If someone is in crisis, they should seek immediate help, such as contacting 911.
People may wish to contact the following organizations:
The National Alliance on Mental Illness HelpLine at 1-800-950-6264 or helpline@nami.org.
Mental Health America for support and further resources.
The National Institute of Mental Health for help with mental healthTrusted Source.
When to contact a doctor
It is best for anyone experiencing symptoms of an anxiety disorder to contact a doctor. They may recommend therapy, medications, or a combination of both.
To diagnose an anxiety disorder, doctors will typically carry out a physical examination to check for any underlying conditions and ask a person about their symptoms.
They may also perform a psychological evaluation and compare the person’s symptoms to the American Psychiatric Association’sTrusted Source criteria for anxiety disorders.
Summary
Several types of medication can treat anxiety. The major classes of drugs for anxiety include SSRIs, SNRIs, TCAs, and benzodiazepines.
Other medications that may help include beta-blockers, buspirone, and MAOIs.
A person’s doctor can help them find the right treatment plan for their needs. If a person notices any side effects from their medication, they should contact their doctor as soon as possible.
To alleviate side effects, a doctor may adjust the dosage slowly or recommend another medication or form of therapy. The doctor may also recommend a different drug or altering the dosage if symptoms of anxiety do not improve.