Each anxiety disorder has different symptoms, but Ken Duckworth, MD, the chief medical officer for the National Alliance on Mental Illness (NAMI) and an assistant professor of psychiatry at Harvard Medical School in Boston, says many people with these disorders can benefit from this three-pronged approach: psychotherapy, exercise, and medication.
Each person may need a different combination of these three elements, and in different sequences. “There’s no magic in the treatment of anxiety,” says Dr. Duckworth.
“Some people will get better with psychotherapy alone, while some people might need medication to help them concentrate better on the therapy. Anxiety and depression can decrease motivation to exercise, but medication may give you the energy to do it.” Also, says Duckworth, a patient may need more than one medication.
There are several types of medications used to treat anxiety disorders.
- Beta blockers
Within each of these categories, there are subgroups of drugs that work differently and have their own benefits, risks, and possible side effects.
In particular, SSRIs, or selective serotonin reuptake inhibitors, are the kind of antidepressant that is most often prescribed. They impact a neurotransmitter that has been linked to mood.
“They’re supereffective in treating anxiety disorders [for certain people],” says Beth Salcedo, MD, the medical director of the Ross Center for Anxiety & Related Disorders and a past board president of the Anxiety and Depression Association of America. 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 too abruptly).
It’s important to follow your doctor’s instructions when taking any prescription drug. Talk to your doctor 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 or Sarafem)
- citalopram (Celexa)
- sertraline (Zoloft)
- paroxetine (Paxil, Paxeva, or Brisdelle)
- escitalopram (Lexapro)
- venlafaxine (Effexor)
- duloxetine (Cymbalta)
Common side effects of both SSRIs and SNRIs may include:
- Nervousness or restlessness
- Reduced sexual desire
- Weight gain or loss
- Dry mouth
Other antidepressants that may be prescribed for anxiety include:
- bupropion (Wellbutrin, Zyban, Aplenzin, Budeprion, or Buproban)
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Which Benzodiazepines Are Used for Anxiety?
They are usually prescribed for those with generalized anxiety disorder, panic disorder, and social anxiety disorder.
They can also be used with antidepressants initially while antidepressants take time to work.
“They’re a powerful tool,” says Duckworth, “but you have to be really smart about their use.”
- alprazolam (Xanax or Niravam)
- clonazepam (Klonopin)
- lorazepam (Ativan)
- diazepam (Valium)
Other side effects of benzodiazepines may include:
- Blurred vision
- Tiredness or fatigue
What Other Medications Are Prescribed for Anxiety?
Buspirone (BuSpar) is typically used to treat generalized anxiety disorder. It is often prescribed with an antidepressant.
- Trouble sleeping
“Beta blockers can be very helpful but in a limited way,” says Dr. 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.”
It’s an antihistamine that’s used to treat allergic reactions, but it also works to decrease activity in the brain.
These medications act quickly, like benzodiazepines, but unlike benzodiazepines, they don’t cause addiction.
Additional reporting by Carlene Bauer.