Are anti-anxiety drugs right for you? Learn about common side effects, risks, and how to take them responsibly.
The role of medication in anxiety treatment
When you’re overwhelmed by heart-pounding panic, paralyzed by fear, or exhausted from yet another sleepless night spent worrying, you’ll do just about anything to get relief. And there’s no question that when anxiety is disabling, medication may help. But are drugs always the best answer?
Many different types of medications are used in the treatment of anxiety disorders, including traditional anti-anxiety drugs such as benzodiazepines (typically prescribed for short-term use) and newer options like SSRI antidepressants (often recommended as a long-term anxiety solution). These drugs can provide temporary relief, but they also come with side effects and safety concerns—some significant.
They are also not a cure. In fact, there are many questions about their long-term effectiveness. According to the American Academy of Family Physicians, benzodiazepines lose their therapeutic anti-anxiety effect after 4 to 6 months of regular use. And a recent analysis reported in JAMA Psychiatry found that the effectiveness of SSRIs in treating anxiety has been overestimated, and in some cases is no better than placebo.
What’s more, it can be very difficult to get off anxiety medications without difficult withdrawals, including rebound anxiety that can be worse than your original problem.
I need relief, and I need it now!
So where does that leave you if you’re suffering? Even when anxiety relief comes with side effects and dangers, that can still sound like a fair trade when panic and fear are ruling your life.
The bottom line is that there’s a time and place for anxiety medication. If you have severe anxiety that’s interfering with your ability to function, medication may be helpful—especially as a short-term treatment. However, many people use anti-anxiety medication when therapy, exercise, or other self-help strategies would work just as well or better, minus the drawbacks.
Anxiety medications can ease symptoms, but they’re not right for everyone and they’re not the only answer. It’s up to you to evaluate your options and decide what’s best for you.
Several types of medication can treat the symptoms of anxiety. According to the Anxiety and Depression Association of America (ADAA), the four major classes of drugs for anxiety disorders are as follows:
1. Selective serotonin reuptake inhibitors
According to one article, doctors consider SSRIs to be the first-line drug treatment for anxiety.
SSRIs work by stopping nerve cells in the brain from reabsorbing serotonin, which is 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 do not work for everyone.
People usually take SSRIs for up to 12 monthsTrusted Source to treat anxiety, then gradually reduce the dosage. These drugs are not habit-forming, meaning that they do not usually lead to dependence.
People should consult their doctor or physician before they start reducing or stopping their medication.
2. Serotonin-norepinephrine reuptake inhibitors
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are another class of antidepressant that treats depression and anxiety. Doctors may also prescribe them to treat some chronic pain conditions.
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.
3. Tricyclic antidepressants
Tricyclic antidepressants (TCAs) are an older class of antidepressant drug. Although they may be effective for the treatment of depression and anxiety, doctors often prescribe SSRIs instead, as they cause fewer side effects.
However, TCAs may be useful for some people, especially if other medications do not provide relief.
Examples of TCAs for anxiety include:
- amitriptyline (Elavil)
- imipramine (Tofranil)
- nortriptyline (Pamelor)
Benzodiazepines carry a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
- Taking benzodiazepines with opioid drugs increases your risk for severe sleepiness, respiratory depression, coma, and even death. Alprazolam shouldn’t be taken with an opioid unless there are no other available treatment options.
- Using benzodiazepines, even as prescribed, can lead to physical dependence and withdrawal if you stop taking the drug suddenly. Withdrawal can be life threatening.
- Taking benzodiazepines can also lead to misuse and addiction. Misuse of [drug name] increases your risk of overdose and death.
- Only take benzodiazepines as your doctor prescribes. Talk with your healthcare provider if you have any concerns about safely taking this drug.
Deciding if anxiety medication is right for you
If you’re trying to decide whether or not to treat your anxiety with medication, it’s important to weigh the pros and cons in conjunction with your doctor. It’s also important to learn about the common side effects of the anxiety medication you are considering. Side effects of anxiety medication range from mild nuisances such as dry mouth to more severe problems such as acute nausea or pronounced weight gain. For any anxiety medication, you will have to balance the side effects against the benefits.
Questions to ask yourself and a mental health professional
- Is medication the best option for my anxiety problem?
- Am I willing to put up with unpleasant side effects in return for anxiety relief?
- What non-drug treatments for anxiety might help?
- Do I have the time and am I willing to pursue non-drug treatments such as cognitive-behavioral therapy?
- What self-help strategies might help me get my anxiety under control?
- If I decide to take anxiety medication, should I pursue other therapy as well?
- Is anxiety really my problem? Or is something else going on, such as an underlying health condition or pain, for example?
Questions to ask your doctor
- How will the medication help my anxiety?
- What are the drug’s common side effects?
- Are there any food and drinks I will need to avoid?
- How will this drug interact with my other prescriptions?
- How long will I have to take the anxiety medication?
- Will withdrawing from the medication be difficult?
- Will my anxiety return when I stop taking the medication?