Which Medications Are Used to Treat Anxiety Disorders?

Each person may need a different combination of these elements, and in different sequences. “There’s no magic in the treatment of anxiety,” says Ken Duckworth, MD, the chief medical officer for the National Alliance on Mental Illness and an assistant professor of psychiatry at Harvard Medical School in Boston.

“Some people will get better with psychotherapy alone, while some people might need medication to help them concentrate better on the therapy.” Also, says Dr. Duckworth, someone may need more than one medication.

Here’s what medication treatment for anxiety disorders can look like.

Anxiety Disorders and Medications: The Basics

There are several types of medications used to treat anxiety disorders.

• Antidepressants
• Benzodiazepines
• Other medications

Within each of these categories, there are subgroups of drugs that work differently and have their own benefits, risks, and possible side effects.

“[SSRIs are] super effective in treating anxiety disorders [for certain people],” says Beth Salcedo, MD, the medical director of the Ross Center in Washington, DC. It’s not known exactly how SSRIs work on serotonin to alleviate anxiety, says Dr. Salcedo, but what is known is that they’re not addictive like benzodiazepines are, though they can cause uncomfortable symptoms if people stop taking them abruptly.

It’s important to follow your doctor’s instructions when taking any prescription drug. Talk to them if you’re concerned about the side effects of a medication or if the drug you’re taking doesn’t seem to be alleviating your symptoms.

Which Antidepressants Are Used for Anxiety?

The two classes of antidepressants most commonly used to treat anxiety disorders are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

• fluoxetine (Prozac)
• citalopram (Celexa)
• sertraline (Zoloft)
• fluvoxamine (Luvox)
• paroxetine (Paxil, Paxil CR, Paxeva, or Brisdelle)
• escitalopram (Lexapro)

• venlafaxine (Effexor XR)
• duloxetine (Cymbalta)
• desvenlafaxine (Pristiq)
• levomilnacipran (Fetzima)

• bupropion (Wellbutrin SR, Wellbutrin XL, Aplenzin, Budeprion SR, Budeprion XL)

• Nausea
• Diarrhea
• Sexual side effects
• Headache
• Dry mouth
• Difficulty sleeping
• Dizziness
• Fatigue

Which Benzodiazepines Are Used for Anxiety?

“They’re a powerful tool,” says Duckworth, “but you have to be really smart about their use.”

• alprazolam (Xanax)
• clonazepam (Klonopin)
• lorazepam (Ativan)
• diazepam (Valium)
• chlordiazepoxide
• temazepam (Restoril)
• triazolam (Halcion)

• Trouble breathing
• Drowsiness
• Tiredness or fatigue
• Slowed heart rate
• Low blood pressure
• Fainting

What Other Medications Are Prescribed for Anxiety?

Buspirone is typically used to treat generalized anxiety disorder. It is often prescribed with an antidepressant.

• Drowsiness
• Dizziness
• Headaches
• Nausea
• Light-headedness
• Changes in dreams

“Beta blockers can be very helpful but in a limited way,” says Salcedo. “They are most commonly used for performance anxiety. They are really good for the physical symptoms such as heart racing, sweating, and shakiness, but they work less well for the anxious thoughts that might be causing the symptoms.”

The Takeaway

• While different anxiety disorders have different symptoms, treatment plans for each type often include a combination of psychotherapy and medication.
• Antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and norepinephrine-dopamine reuptake inhibitors (NDRIs), are often the first treatment a doctor will prescribe for an anxiety disorder.
• Benzodiazepines, fast-acting medications that work to enhance the action of a calming chemical in the brain, are typically only offered in the short-term on an as-needed basis, because they can cause dependence, tolerance, and withdrawal.
• Other medications, including buspirone, antihistamines, and certain heart medications called beta blockers, can also be prescribed to treat anxiety disorders.

Additional reporting by Carlene Bauer.