Anti-Anxiety Medications

What are anti-anxiety medications?

“Anti-anxiety medications” describes several different types of drugs used to reduce symptoms of anxiety disorders. Some are taken daily for longer-term relief; others act quickly and are used short-term.

What they’re used for

Generalized anxiety disorder, panic disorder, social anxiety disorder and some other anxiety-related conditions. The choice depends on the type of anxiety, other health conditions and individual factors.

How they work

• SSRIs and SNRIs: antidepressants that adjust serotonin (and norepinephrine) signaling over several weeks.
• Buspirone: acts on serotonin receptors; used for generalized anxiety and takes weeks to work.
• Benzodiazepines: enhance the calming effect of the neurotransmitter GABA and act within minutes to hours.
• Hydroxyzine: an antihistamine sometimes used for short-term anxiety relief.

How they’re taken

Most are taken by mouth. Daily medications such as SSRIs are taken regularly; some fast-acting medications may be prescribed for limited periods. Your prescriber will provide instructions — this page does not provide dosing guidance.

Common side effects

• SSRIs/SNRIs: nausea, headache, sleep changes, sexual side effects.
• Buspirone: dizziness, nausea, headache.
• Benzodiazepines: drowsiness, dizziness, slowed thinking, unsteadiness.
• Hydroxyzine: drowsiness, dry mouth.

Serious side effects

Seek medical help for signs of an allergic reaction, extreme drowsiness or slowed breathing, confusion, falls, worsening mood or thoughts of suicide.

Warnings

• Benzodiazepines can cause dependence. Stopping suddenly can cause serious withdrawal, including seizures — changes should be planned with a prescriber.
• Combining benzodiazepines with opioids, alcohol or other sedatives can be life-threatening.
• Older adults are at greater risk of falls and confusion with sedating medications.

Interactions

Sedating medications can interact with alcohol, opioids, sleep medications and antihistamines. SSRIs and SNRIs have their own interactions. Share a full list of medications and supplements with your prescriber and pharmacist.

Longer-term options and quick-acting options

It helps to separate medicines used for ongoing treatment from those used for short-term relief.

• SSRIs and SNRIs (for example sertraline, escitalopram, venlafaxine) are generally first-line treatments for many anxiety disorders. They are taken regularly and typically take several weeks to work. They are not addictive, but stopping abruptly can cause discontinuation symptoms.
• Buspirone is a non-sedating medicine used for generalized anxiety, which also takes a few weeks to have an effect and isn’t addictive.
• Hydroxyzine is an antihistamine that can have a calming effect and is sometimes used for short-term anxiety; it can cause drowsiness.
• Beta-blockers, such as propranolol, are sometimes used to ease physical symptoms like trembling and a racing heart in performance situations, although they don’t treat anxiety itself.
• Benzodiazepines (for example lorazepam and clonazepam) act quickly but carry risks of tolerance, dependence and withdrawal, so they are generally recommended only for short periods or specific circumstances.

Why benzodiazepines need special care

Benzodiazepines can reduce anxiety within minutes to hours, which is why they can feel very helpful. The same quick relief can lead to a pattern of reliance, and the body can adapt so that stopping causes rebound anxiety, insomnia and, in severe cases, seizures. They also carry an FDA boxed warning about misuse, dependence and the dangers of combining with opioids, which can slow breathing to a life-threatening degree. Combining with alcohol or other sedatives raises the same risk. If you take one regularly, don’t stop suddenly; your prescriber can plan a gradual change. Many online services don’t prescribe benzodiazepines at all; see our guide to online anxiety treatment.

Medication and therapy together

Therapy such as CBT and exposure therapy teaches skills that last after treatment ends, while medication can lower the intensity of symptoms enough to make therapy easier. For moderate to severe anxiety, combining both is common. See therapy for anxiety.

Special situations

• Pregnancy and breastfeeding: the balance of risks and benefits differs for each medicine, so discuss plans with your care team before starting or stopping.
• Older adults: sedating medicines raise the risk of falls and confusion, and options are chosen carefully.
• Children and teenagers: SSRIs and SNRIs carry a boxed warning about suicidal thoughts in people under 25, and close monitoring is recommended.
• Substance use: tell your prescriber about alcohol and drug use, which affect which options are safe.
• Other conditions: thyroid, heart and breathing conditions can influence choices.

Lifestyle and anxiety

Caffeine, nicotine and alcohol can worsen anxiety symptoms, and regular sleep, movement and relaxation skills help. See how to calm your mind, why am I anxious for no reason and anxiety. If anxiety feels unmanageable or you have thoughts of harming yourself, seek help right away; see Get Help Now.

Questions to ask your healthcare professional

• Is this medication meant for daily, longer-term use or short-term relief?
• How long until it works, and how will we judge whether it’s helping?
• What are the risks of dependence, and how would I stop safely?
• Should I combine this with therapy?

Online services can prescribe non-controlled anxiety medications when appropriate. Lemonaid Health prescribes SSRIs and SNRIs, and clinicians on Sesame may also prescribe buspirone or hydroxyzine. Neither prescribes benzodiazepines.