Best Medication Options for Anxiety

Most of us want to know what’s the best of the best when exploring options for everything from furniture to clothing or food. This mindset, however, doesn’t always work when it comes to our healthcare options. This is because what the “best” is will be unique to each person. 

The best treatment for anxiety is individualized care, because people respond differently to medications, and there are other factors involved that impact outcomes. If two people with the same anxiety symptoms take the same medication, one may experience relief while the other doesn’t. 

Common Types of Anxiety Medications

There are many types of anxiety medications, and we review some of the most commonly utilized ones here in this section.

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are thought to work by increasing the brain’s level of available serotonin by limiting how much is absorbed; this process is referred to as reuptake. It is also thought to increase activity in some parts of the brain and decrease it in others. Common examples of SSRIs for anxiety include sertraline, escitalopram, fluoxetine, paroxetine, and citalopram.

Some of the potential benefits include improving sleep, increasing appetite, regulating mood, and improving pain perception. Some of the potential side effects include weight gain, digestive problems, headaches, sexual dysfunction, insomnia, anxiety, and increased suicide risk. 

• If you or someone you know is experiencing thoughts of suicide, please call or text the Suicide and Crisis Hotline at 988.

SNRIs

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are similar to SSRIs in that they block the reuptake of serotine but they also limit the reuptake of norepinephrine. Common SNRIs used for treating anxiety include duloxetine and venlafaxine. 

The potential benefits of these medications are similar to those of SSRIs, and they help improve mood, alertness, and sleep. The potential side effects are also similar, including increased risk of suicide and serotonin syndrome. 

SSRIs vs SNRIs

Some people benefit more from either an SSRI or SNRI, and this often depends on the type of anxiety one experiences.

‍Studies show that both types are effective options for treating generalized anxiety disorder. SSRIs are used more often for disorders such as panic disorder and post-traumatic stress disorder, while SNRIs are more often used for people with chronic pain. Check out our article on SSRIs vs SNRIs to learn more. 

• Important note: Taking two or more medications that impact serotonin (SSRIs and SNRIs) or herbal remedies (like St. John’s Wort) can cause serotonin syndrome, which is a serious and potentially deadly nervous system condition, with symptoms including disorientation, very high fever, digestive problems, nausea or vomiting, confusion, dilated pupils, cardiovascular problems, and muscle tremors or shivers. It’s vital to tell your doctor about all the medications and supplements you are taking to prevent this. Anyone who suspects they may have serotonin syndrome should seek immediate medical attention. 

Benzodiazepines

Benzodiazepines for anxiety provide short-term relief and are most often used for briefer periods. These are an effective option for many people for managing short-term anxiety. Some common side effects include dizziness, confusion, drowsiness, and impaired concentration. 

However, these medications are used with caution due to the potential for dependency and withdrawal complications. When people become physically dependent on these medications, this can actually increase anxiety and put people at risk for seizures while withdrawing.

Other Anxiety Medication Options

Buspirone

Buspirone is a type of azapirone medication, and this class of medications has less dependence risk than benzodiazepines, making them a safer option for many people.

Beta Blockers

Beta blockers are considered off-label medications when used to treat anxiety, since they haven’t been officially approved for the treatment of anxiety disorders. They help to reduce high blood pressure, and so they are commonly prescribed for public speaking or other infrequent anxiety-provoking events. People with anxiety disorders may be more likely to benefit from another type of medication.

Side Effects and Safety Considerations for Anxiety Medications

When making a decision about taking medication for anxiety, it’s important to consider the short-term vs long-term effects. Many medications take some time to work, since they need to build up in the body’s system. 

Another important consideration is the likelihood of developing dependency on the medication, which is more likely with some classes of medications than others. Many medications need to be monitored by your prescribing healthcare provider if you stop taking them to avoid unpleasant or even dangerous withdrawal symptoms. 

Additionally, as discussed above, taking more than one medication that limits the reuptake of serotonin can put people at risk of developing medical complications. Anxiety medications can also interact with other types of medications and even supplements. Ensure you tell your prescriber about all the medications and supplements you take to avoid harmful medication interactions or complications.

Medication vs Therapy for Anxiety

Many people want to consider all their options and may wonder if taking medication or going to therapy to address their anxiety is better for them.

‍Research shows that cognitive-behavioral therapy (CBT) and medications both help to reduce anxiety. In general, talk therapy is more helpful for many people in the long-run because it helps people address the circumstances, thoughts, beliefs, traumatic events, challenging experiences, and other factors that are contributing to their anxiety. Many people benefit from a combination of therapy and medication.

How to Talk to a Doctor About Anxiety Medication

Professional guidance and consultation are essential for making an informed decision about what medications are right for you. 

• Risks and benefits: When choosing anxiety medications, benefits must be weighed against risks, and your healthcare provider can help you explore the potential pros and cons of different medications, such as side effects. 
• Potential dependency: If you have a history of substance use concerns or if there is a family history, it may be a good idea to discuss this with your prescriber and request that they recommend a nonaddictive anxiety medication.
• Expectations matter: It’s important to have realistic expectations for treatment. Ask your prescriber what you can expect in terms of results and about your treatment plan, as many medications need the dose to be slowly increased to achieve maximum results. 
• Monitor progress: Discuss how you will track your progress to determine whether the medication is working for you.
• Know your options: Request information on other options if the medication you try does not work for you. Also ask about therapy, peer support, and other lifestyle changes that can help you better manage your anxiety.

Takeaway 

There are many effective treatment options for anxiety, and recovery from mental health concerns is possible. Accurate diagnosis by a licensed healthcare clinician matters for effective treatment and management of mental health conditions. 

If you or your loved one is looking for mental healthcare or crisis support and prevention, reach out to us at Willow Health today. We offer same-day or next-day appointments with both a psychotherapist and a psychiatric medication clinician, who can assess your needs and identify a plan for individualized care. 

Sources

Commonly prescribed antidepressants and how they work | NIH MedlinePlus Magazine 

Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review 

Assessment of the Antidepressant Side Effects Occurrence in Patients Treated in Primary Care 

Systematic review and meta-analysis: Dose–response curve of SSRIs and SNRIs in anxiety disorders

Serotonin norepinephrine reuptake inhibitors: a pharmacological comparison - PubMed 

Full article: Comparing the efficacy of benzodiazepines and serotonergic anti-depressants for adults with generalized anxiety disorder: a meta-analytic review 

Treatment of Benzodiazepine Dependence | New England Journal of Medicine 

Azapirones for the treatment of anxiety – an overview - World Scientific News 

Propranolol versus Other Selected Drugs in the Treatment of Various Types of Anxiety or Stress, with Particular Reference to Stage Fright and Post-Traumatic Stress Disorder 

How Do I Choose Between Medication and Therapy?