What Is the Best Medication for Teenagers With Anxiety?

Anxiety disorders are the most common psychiatric conditions that today’s youth face. You may have heard that more and more teens are experiencing anxiety, but even younger children can be at risk. According to the CDC, almost 1 in 10 children between ages 3 and 17 have been diagnosed with anxiety at some point. And, in teens, almost 1 in 3 have had an anxiety disorder at some point.

If your child or teen is diagnosed with an anxiety disorder, their pediatrician may recommend medication — especially if their symptoms are causing problems in everyday life. Medication may be used short or long term. And it’s often combined with therapy like cognitive behavioral therapy (CBT) for best results. 

Let’s take a look at the options, so you’re familiar with some of the best medications for anxiety in teenagers. 

SSRI antidepressants for anxiety in teenagers

For many children and teens with an anxiety disorder, selective serotonin reuptake inhibitors (SSRIs) are a good first choice. These medications seem to work well for many anxiety disorders, and they’re generally well tolerated. Some of these medications are FDA approved for childhood anxiety disorders and related conditions. Others are used “off-label” in children and teens. 

Commonly prescribed SSRIs for children and teens include:

• Citalopram (Celexa)

• Escitalopram (Lexapro)

• Fluoxetine (Prozac)

• Fluvoxamine (Luvox)

• Paroxetine (Paxil)

• Sertraline (Zoloft)

It can take about 2 weeks to notice improvement and up to 6 weeks to see the full anxiety-lowering effects of SSRIs. So be patient if you decide that your child or teen should begin taking this type of medication.

SNRIs and other antidepressants for anxiety

Other antidepressants can help treat anxiety in kids too. These include serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants. Though these medications also work well, they often come with more side effects. Because of this, they’re usually reserved for a second- or even third-choice option.

Examples include:

• Venlafaxine ER (Effexor)

• Duloxetine (Cymbalta)

• Clomipramine (Anafranil)

• Imipramine (Tofranil)

Benzodiazepines for anxiety

Benzodiazepines (“benzos”) are a type of short-term medication for anxiety. They treat anxiety by lowering certain types of activity in the brain that may be connected to anxious thoughts, feelings, and behaviors. Examples include:

• Lorazepam (Ativan)

• Clonazepam (Klonopin)

• Alprazolam (Xanax)

Compared to antidepressants, benzos may make anxiety go away very quickly — usually within minutes to hours. But in general, they’re not typically a great first-choice option. They’re linked to misuse and dependence. They can also have many side effects, like irritability and drowsiness.

Because of the risks and side effects, benzos are usually only used “as needed” in children and teens for managing occasional anxiety-provoking situations. They’re also sometimes used temporarily for a few weeks while waiting for a SSRI or SNRI to start working.

Other medications for anxiety

There are several other medications that are sometimes used off-label in children and teens with anxiety. These medications are usually only used as an add-on medication or if other types of medication and therapy haven’t worked. They’re also sometimes used if an antidepressant isn’t a good option.

Examples include:

• Buspirone (Buspar)

• Hydroxyzine (Atarax)

• Propranolol (Inderal)

What are the signs and symptoms of anxiety in children and teens?

Anxiety in children and teens can show up in many ways. Possible symptoms can be physical, such as: 

• Shortness of breath

• Poor digestion

• Muscle tension

• Insomnia or trouble sleeping

• Headaches or dizziness

• Problems swallowing

• Nausea or vomiting

• Appetite changes

Symptoms can be emotional, too, including:

• Clinginess

• Acting scared

• Crying

• Tantrums or outbursts

• Failing to speak

• Freezing up

• Avoidance of certain people, places, or activities

• Poor school performance

• Suicidal thoughts or behavior, even if not depressed

If a child or teen has these types of symptoms most days of the week, it may be a sign that they have an anxiety disorder. Keep in mind that some children and teens might be embarrassed about their feelings or not mention anxiety to their parents. Or their symptoms might just appear in certain environments — like at home, school, or when hanging out with friends.

Teens might also deal with anxiety in different ways, like acting out with drugs, alcohol, or sex. They might also seem less involved in social activities or school, or they may be reluctant to hang out with friends. Teens in particular might feel more comfortable admitting they have physical symptoms, like a headache or stomachache, compared to admitting other worries or fears.

What causes anxiety in children and teens?

Understandably, parents are often concerned when they learn that their child or teen has anxiety and will wonder what caused it.

It can be tough to pinpoint a single cause. But anxiety in children and teens may be related to:

• Genetics: Some people, children included, are genetically “wired” to have certain health conditions, including mental health conditions like anxiety and depression.

• Family history and/or household exposure: Even if there’s no genetic basis for a child to have anxiety, growing up in a household with someone who has anxiety or other mental health conditions can increase a child’s likelihood of developing the condition.

• Difficult situations at home or school: Like in adults, challenging situations such as deaths, loss of friends, bullying, and other stressful scenarios can trigger anxiety in children. Abuse or neglect is also associated with anxiety.

• Medical problems: Some medical illnesses can cause anxiety symptoms in children and teens. These include migraines, inflammatory bowel disease, asthma, thyroid problems, and more.

• Alcohol and drugs: Though teen drug and alcohol use has gone down in the last decade, it’s still a problem for many teens. Using these substances can cause anxiety.

• Social media: Many tweens and teens use social media. Though social media can be positive for many young people, it’s also linked to anxious feelings. Tweens and younger teens may be especially vulnerable.

• A lack of sleep: Many tweens and teens don’t get enough sleep on school nights. Not getting enough sleep can cause mood changes, problems with concentration, and anxiety.

Can neurodevelopmental conditions like autism and ADHD cause anxiety?

Yes, neurodevelopmental disorders like autism and attention-deficit hyperactivity disorder (ADHD) can cause anxiety in children and teens. This is true even though they’re not “officially” categorized as anxiety disorders.

Conditions linked to anxiety in kids include:

• Learning disorder, like dyslexia

• Intellectual disability 

• Speech, language, and communication disorders

• Movement or tic disorders, like Tourette syndrome

• Childhood-onset fluency disorder (stuttering)

• Autism spectrum disorder (ASD)

• ADHD

These conditions can lead to anxiety at home and school, as well as in social situations or relationships. Keep in mind that it’s also possible to have a neurodevelopmental condition and an anxiety disorder at the same time.

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Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

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