If you’ve been diagnosed with anxiety, you know that some symptoms can feel overwhelming. Depending on the severity of your condition, they might even get in the way of your day-to-day activities and responsibilities and prevent you from living the life you want.
Generalized anxiety disorder (GAD) is one of the most common mental health conditions diagnosed in the U.S. Anxiety impacts 19% of the population nationwide. But it’s very treatable. Often, you may be able to manage your anxiety by engaging in regular therapy sessions and focusing on coping skills that help ease your physical and emotional symptoms.
But sometimes, that’s not enough. If you’ve been recently diagnosed with anxiety and feel like therapy alone is not helping your symptoms, your provider may suggest you try a medication in conjunction with your regular sessions.
If you haven’t considered taking medication for a mental health issue before, you might be concerned about how it will make you feel and when you will start to notice an improvement in your anxiety. You might also be worried about side effects. Your provider is the best source of information for your unique needs, but this overview on types of medication and how they differ is a good starting point for that conversation.
Types of Anti-Anxiety Medications
There are several categories of medications prescribed for anxiety, and they all work in slightly different ways. Your provider may have a recommendation for which kind may work best for you, but understanding what they are, how they work, and what kind of potential side effects you may experience will help you have an educated discussion.
Selective Serotonin Reuptake Inhibitors (SSRIs)
These medications are a class of anti-anxiety drugs (also referred to as antidepressants) that increase the levels of serotonin in the brain. Serotonin is a neurotransmitter, or messenger chemical that communicates between nerve cells in the brain. Scientists believe it influences your moods, emotions, and sleep patterns. Usually, when serotonin is released into the brain, it binds to nerve cell receptors and is eventually reabsorbed into the nerve cell, also known as “reuptake.”
SSRIs block, or inhibit, that reuptake process, allowing more serotonin to be available in the brain to pass messages along between brain cells. Although anxiety and depression are not necessarily caused by low serotonin levels, an increase in serotonin can help improve certain symptoms.
There are five SSRIs currently approved by the U.S. Food and Drug Administration (FDA) to treat mental health conditions like depression and anxiety. They are generally considered safe for most people and are usually the first type of medication your provider will suggest.
- Paroxetine (Brand name: Prozac)
- Sertraline (Brand name: Zoloft)
- Citalopram (Brand name: Celexa)
- Paroxetine (Brand name: Paxil)
- Escitalopram (Brand name: Lexapro)
If you and your provider decide to try medication to treat your anxiety, they will probably start you on the lowest dose at first. They’ll wait to see how the drug impacts your anxiety and whether you get side effects. Most side effects are not serious but may include:
- Upset stomach, vomiting, or diarrhea
- Sweating
- Disturbances in your sleep
- Dry mouth
- Headache
- Restlessness
- Changes in appetite
- Sexual side effects, including decreased libido
It’s important to note that you may experience side effects initially that will fade once your body adjusts to the medication. Talk to your provider if you feel your side effects are severe enough to stop you from taking the medication consistently. Even if you decide to stop taking a medication, you should never stop “cold turkey.” This can cause a temporary imbalance in your brain that produces even worse symptoms than before, like fever, nausea, panic attacks, or impaired coordination. Always work with your provider to ease off medication slowly.
Although all these medications work the same way, you may find more success with one versus another, depending on your unique brain chemistry. So, if one medication doesn’t work well for you, it’s a good idea to try a different one before giving up all together.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Working in a similar way to SSRIs, SNRIs are a class of medications that can boost levels of both serotonin and norepinephrine, which is another neurotransmitter. Increasing norepinephrine can also improve mood, energy levels, and concentration. These medications may also help relieve chronic pain, in addition to easing symptoms of anxiety and depression.
There are currently four SNRIs commonly used to treat anxiety disorders:
- Duloxetine (Brand name: Cymbalta)
- Desvenlafaxine (Brand name: Pristiq)
- Venlafaxine (Brand name: Effexor XR)
- Levomilnacipran (Brand name: Fetzima)
They work in the brain in similar ways and can cause similar side effects, but again – depending on your brain chemistry and unique needs, one may work better than another. Your provider will help you figure out which one is best for you. Side effects may vary and can include:
- Nausea
- Dry mouth
- Headache
- Dizziness
- Sweating
- Insomnia
- Sexual side effects
- Loss of appetite
Benzodiazepines (Benzos)
Often just referred to as benzos, benzodiazepines are a different classification of medications for treating anxiety and other mental health conditions. They start working immediately to calm you down and produce a feeling of relaxation, which will help temporarily ease your anxiety symptoms.
Benzos work in your brain by increasing the effect of another neurotransmitter, gamma-aminobutyric acid (GABA), making your nervous system less active. Benzos work like tranquilizers or sedatives, reducing extreme systems of anxiety like panic attacks or extreme fear.
Unlike SSRIs or SNRIs, benzos work quickly, but don’t stay in your system for very long. They are not considered appropriate for regular, long-term use. They can be safe and effective when used as directed, but they can also be addictive and have the potential to be abused.
The most commonly prescribed benzos are:
- Alprazolam (Brand name: Xanax)
- Chlordiazepoxide (Brand name: Librium)
- Diazepam (Brand name: Valium)
- Lorazepam (Brand name: Ativan)
You may experience side effects when taking benzos, such as dizziness, impaired coordination, or drowsiness. Since they have a depressive effect on the body, they should never be mixed with alcohol or other recreational drugs.
Beta-Blockers
Although not approved to treat anxiety by the FDA, beta-blockers are sometimes prescribed by doctors to help with symptoms related to your “fight or flight” reaction, which can be heightened during a panic attack or other extreme anxiety-provoking situation.
Beta-blockers are typically used to treat heart-related issues like high blood pressure, heart failure, or an irregular heartbeat, but they might also be prescribed off-label to manage anxiety symptoms – especially for those who might not be able to take other classes of anti-depressants.
Beta-blockers work by literally blocking the effects of epinephrine or adrenaline to reduce the intensity of that fight or flight feeling and lessen the physical effects. Like benzos, beta-blockers work best to manage short-term anxiety about specific situations. They work quickly to help ease anxiety symptoms like:
- Fast heart rate
- Shaky hands and voice
- Sweating
- Dizziness
Although there are multiple beta-blockers, most of these are more commonly used by cardiologists or primary care providers. Psychiatrically the most common medication is Propranolol (Brand name: Inderal).
Other Medications
This article is certainly not an exhaustive list of medications used to treat anxiety, and talking to your provider is the best way to understand what might work well for you. Other commonly prescribed medications include:
Hydroxyzine (Brand name: Vistaril) is an antihistamine that also seems to boost serotonin levels in the brain. It may make you sleepy (similar to how Benadryl does) so it’s best for anxiety related to insomnia. It’s not meant to be used for longer than a few months.
Buspirone (Brand name: Buspar) works similarly to SSRIs and SNRIs by regulating the levels of dopamine and serotonin in your brain. It belongs to a group of drugs called anxiolytics, which help to lessen anxiety symptoms.
Gabapentin (Brand name: Neurontin) is FDA-approved to control seizures and treat nerve pain but is also used off-label to treat anxiety disorders. It works by acting like a neurotransmitter in the brain called GABA, which has a calming effect. Gabapentin can be helpful in managing conditions like panic disorder but is typically not prescribed as the only medication.
When to Talk to a Provider
If you think you might benefit from medication or have additional questions about side effects, it’s a good idea to talk to a mental health professional. MindGlow Health offers talk therapy and psychiatric care through online appointments with licensed providers who are experienced and passionate about what they do. The company was built on the foundation of a well-established behavioral health organization, where thousands of people nationwide have sought care for their mental health concerns.
Learn more about the services we provide or get started today with one of our experienced, passionate online providers to take the first step towards a healthier, happier you.
