Imagine waking up in the morning with a tight feeling in your chest and your body in fight-or-flight mode with no logical explanation why. Your palms are sweaty and your heart is racing, yet there’s no immediate threat. This is true for your body, but to your mind, the threat seems real, and it encourages your body to react as though it’s being chased. You’re in survival mode.
This is what reality can look like for someone living with an anxiety disorder like generalized anxiety disorder (GAD) or social anxiety disorder (SAD). Although it can be challenging to manage anxiety before a diagnosis, there are plenty of anxiety medication and treatment options available today to improve a person’s quality of life.
Medication’s Role in Anxiety Treatment: Understanding the Integration of Medications
Anxiety is the most common mental health condition in the United States, affecting around 19% of the population (more than 40 million adults). There are many options for anxiety treatment today, ranging from types of therapies to anxiety pills. The most effective treatment option for a person with anxiety is usually a combination of the two: an integration of talk therapy and anxiety medication to help a person attain a more enjoyable day-to-day level of functioning.
One of the most effective forms of talk therapy for treating anxiety is cognitive behavioral therapy (CBT). This is commonly used in collaboration with selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) to create a long-term way to safely manage anxiety disorders. Benzodiazepines are also sometimes prescribed for treating anxiety, but they’re exclusively for short-term use and don’t offer a long-term solution or improved quality of life.
A 2018 paper looked at the efficacy of combined CBT and SSRI treatment for anxiety disorders in young people. It concluded that while CBT was potentially more effective long-term than SSRIs alone, the combination of the two remained one of the most beneficial treatment options.
What Are the Top 10 Medications for Anxiety?
There are many medications doctors can prescribe to manage anxiety. Ten of the most common anxiety medications are:
- Alprazolam (Xanax)
- Atenolol (Tenormin)
- Duloxetine (Cymbalta)
- Lorazepam (Ativan)
- Buspirone (Buspar)
- Propranolol (Inderal)
- Sertraline (Zoloft)
- Clonazepam (Klonopin)
- Escitalopram (Lexapro)
- Diazepam (Valium)
Generally speaking, these fall into four common types of anxiety medications: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, and beta blockers.
Selective Serotonin Reuptake Inhibitors (SSRIs): Exploring How SSRIs Address Anxiety Symptoms
SSRIs are the type of anxiety medication most commonly prescribed for managing anxiety disorders in the long term. SSRIs are a type of antidepressant medication; 13.2% of American adults (18+) reported taking antidepressants between 2015 and 2018, according to the CDC, demonstrating how commonly they’re prescribed in the United States.
These medications work to reduce anxiety symptoms by boosting serotonin levels in the brain. Serotonin is a chemical messenger or “neurotransmitter” that relays messages between neurons. Normally, these neurons will reabsorb serotonin. SSRIs prevent this from happening, freeing up more serotonin for better messaging between neurons.
While this can be effective for conditions like GAD or SAD, low serotonin levels in the brain aren’t the only cause of anxiety. Therefore, taking SSRIs isn’t a cure for anxiety but rather a tool that can help some people better manage their symptoms. In particular, people with phobias triggered by a specific thing or event may benefit more from CBT or short-term anxiety medication options.
Taking SSRIs doesn’t provide immediate relief from feelings of stress and anxiety. Rather, this long-term treatment strategy requires a person to slowly ease into taking the medication over the course of a few days or a week. After several weeks, the effects of the antianxiety medication begin to work on the brain, altering how it functions.
SSRIs are some of the most common anti-anxiety medications because they are safe and quite effective in managing conditions like generalized anxiety disorder. Importantly, most SSRIs are not chemically addictive, unlike many other drugs. In terms of side effects, you may experience sexual dysfunction, headaches, sleep issues, dizziness, gastrointestinal problems, and dry mouth. In rare cases, people have reported experiencing worsened anxiety.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Understanding How SNRIs Impact Anxiety
While SSRIs are often the first choice prescription for physicians treating anxiety disorders, SNRIs are another common option. Serotonin-norepinephrine reuptake inhibitors work similarly to SSRIs, but rather than just increasing the levels of serotonin in the brain, they also boost norepinephrine levels. Norepinephrine is a core part of the fight, flight, or freeze response, and adjusting it along with serotonin can cause a notable anxiety reduction. These are chemical messengers that work to regulate the mood, appetite, sexual drive and social nature of a person.
SNRIs are effective in treating depression and chronic nerve pain in addition to anxiety. So, a doctor may choose to prescribe SNRIs instead of SSRIs when a patient has conditions besides anxiety that are also affecting their behavior and daily life.
Like SSRIs, SNRIs are extremely safe and effective medications. While some opioid SNRIs are addictive, most are not. Both classes of drug share many potential side effects, such as sexual dysfunction, dizziness, and headache. Depending on your unique circumstances, the increase of norepinephrine levels can sometimes cause added anxiety and higher blood pressure.
Both SNRIs and SSRIs can result in a rare, but serious, complication called serotonin syndrome, which occurs when there is excess serotonin in the body. Symptoms of this range from nausea and vomiting to fever, seizures, and delirium.
Benzodiazepines: Examining the Use of Benzodiazepines for Short-Term Anxiety Relief
SSRIs and SNRIs are long-term medication options that patients can stay on for weeks, months or years to better manage an ongoing anxiety disorder. But some forms of anxiety, such as panic attacks, require a short-term treatment option instead. This is when a doctor might prescribe benzodiazepines (like lorazepam) to reduce stress immediately for a specific period. This type of anxiety treatment may be prescribed to aid a patient in getting through a specific event in life (such as someone with a phobia about flying to take in-flight). As of 2018, around 12.6% of the U.S. population reported using benzodiazepines within the past 12 months.
These anxiety meds work quickly by increasing the activity level of GABA (a neurotransmitter in the brain that creates a feeling of calm in the body). GABA has sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant abilities — meaning benzodiazepines can treat a wide range of symptoms, especially in cases of depression and anxiety. Taking benzodiazepines can also make you drowsy.
Because benzodiazepines are so powerful, they have much more notable benefits while also carrying more serious risks. Improvements in anxiety symptoms often occur very quickly. They also treat problems that other drugs might not, such as insomnia.
Most of the side effects stem from their muscle relaxation and sedative abilities. Drowsiness and dizziness are typical, as is a drop in focus and alertness. Poor libido, erectile problems, or another form of sexual dysfunction is also possible. Over time, benzodiazepines may actually trigger feelings of depression and general anxiety, as well as agoraphobia, social anxiety, and thoughts of suicide.
Benzodiazepines are also very addictive, and most people develop a tolerance to the drugs within a matter of weeks. For these reasons, doctors typically only prescribe these medications for short-term use.
Beta Blockers: A Targeted Option for Physical Symptoms
Unlike the others on this anxiety medication list, beta blockers were not originally antidepressants or anti-anxiety drugs. Instead, they reduce blood pressure. This can be good for managing the more physical symptoms of anxiety, like a rapid heartbeat or trembling.
Each beta blocker works slightly differently, but they all focus on reducing blood pressure. Most accomplish this by blocking the hormone epinephrine, known more commonly as adrenaline. This slows down your heart beat. Some beta blockers also widen your blood vessels to improve blood flow.
Like many other cardiovascular drugs, beta blockers can affect blood flow to the extremities. You might notice this as cold hands or feet or even a slight bluish coloration in these areas. Some people have feelings of fatigue. Weight gain is also possible. Though rare, some people have reported worse feelings of depression, shortness of breath, and sleeping troubles.
Factors to Consider When Choosing an Anxiety Medication
When discussing your anti-anxiety medication options with your healthcare team, you have several factors to consider. The most important are probably your individual symptoms and their severity. If your anxiety is not affecting your day-to-day life, there may be no need to use medications at all. However, if your symptoms are actively hindering you from living your life, the pharmaceutical treatment path may be an effective way to manage them.
Additionally, doctors need to consider your medical history and current medications. For example, beta blockers may inhibit signs of low blood sugar in people with diabetes, so they may not be the best choice in these cases. If you have a history of substance abuse, more addictive benzodiazepines may not be right for you.
Your current medications also play a role in what anxiety medications to take. Interactions between drugs may inhibit their effectiveness or actively harm you. SSRIs and SNRIs can interact with painkillers, other antidepressants, and appetite suppressants among many others. Benzodiazepines can interact with contraceptives, antibiotics, antifungal agents, and antidepressants, as well as alcohol and opioids.
Lifestyle factors are also important. The sexual dysfunction side effects that occur with most anti-anxiety medications may be unacceptable for you. Discuss this with your doctor and find out what options are available.
Frequently Asked Questions
Need Help?
Treatment can begin quickly and discreetly, get started now
Collaborative Treatment: Consulting Health Care Providers for the Most Suitable Anxiety Medication
The best anxiety medication for you is the one you and your trusted counselor and/or physician determine is most effective based on your age, health, lifestyle and cause of anxiety. Talking to a professional about the triggers for your anxiety and getting to the root cause of these thoughts and stresses can help you determine whether long-term or short-term medication options in combination with therapy for anxiety make the most sense for managing your condition.
At FHE Health, we know how much of a struggle it can be to wake up in a state of anxiety and try to seize the day without any support. The team of compassionate professionals at FHE Health is standing by 24/7 to take your call and discuss the available treatment options with you. From CBT to group therapy options, there’s a treatment program and plan here for everyone. Contact us today to learn more and find out how we can support you on your wellness journey.
