Getting Anxiety Medication: 9 Things to Know When Starting Treatment

Most people experience some type of anxiety throughout their life. Some amount of anxiety is normal, but anxiety can often go undiagnosed and untreated.

Anxiety has the potential to affect a person’s ability to handle normal daily activities. It’s also possible to feel anxiousness or fear while encountering specific situations, objects, or moments. In these types of situations, medications are one option to treat anxiety. 

Anxiety disorders are treatable. But treatment can slightly vary, depending on the specific condition and symptoms. Generalized anxiety disorder (GAD) is a common type of anxiety, but several other anxiety disorders also affect many people.

Here, we’ll discuss things you should know when you’re starting a new treatment, plus the first steps to getting anxiety medication.

Living With Generalized Anxiety Disorder: Worries Sometimes Get in the Way of Ordinary Life

Written by Natalie Pompilio

What are the different types of anxiety medications?

Several medications can treat anxiety. They help control anxiety symptoms and can allow you to better carry out daily activities like school, work, and personal relationships.

Antidepressants and benzodiazepines are common anxiety medications, but other ones are available, too.

Antidepressants

Antidepressants are often used to treat depression. But they can also help with symptoms of anxiety. In most cases, they’re actually a first-choice anxiety treatment option.

There are two main groups of antidepressants used to treat anxiety: selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs).

Examples of SSRIs include:

• Citalopram (Celexa)

• Escitalopram (Lexapro)

• Fluoxetine (Prozac)

• Paroxetine (Paxil)

• Sertraline (Zoloft)

Examples of SNRIs include duloxetine (Cymbalta) and venlafaxine ER (Effexor XR).

Tricyclic antidepressants like amitriptyline and monoamine oxidase inhibitors like phenelzine (Nardil) are also used. But they’re older antidepressants that aren’t as commonly prescribed as SSRIs and SNRIs.

Benzodiazepines

A popular group of anti-anxiety medications are benzodiazepines. These help treat symptoms like panic attacks, fear, or worrying. They’re effective treatment options and quick to work. But they should only be used for a short period of time to lower the risk of side effects.

Examples of benzodiazepines include alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan).

Other medications for anxiety

Although SSRIs, SNRIs, and benzodiazepines are common treatments for anxiety, other medications are used, too.

Buspirone (Buspar) is an anxiety medication that may be helpful for people who have long-term (chronic) anxiety.

Hydroxyzine pamoate (Vistaril) is a possible second-choice treatment for GAD. It may also be a good choice for people who don’t respond well to benzodiazepines or who have struggled in the past with substance use.

Certain beta blockers — like propranolol (Inderal) — are sometimes used off-label for performance anxiety. They can help prevent symptoms like a fast heartbeat, shaking, and blushing before moments like public speaking.

What is the best anxiety medication?

There isn’t one best medication for anxiety. SSRIs, SNRIs, and benzodiazepines are often used, but the best medication for you may not be the best medication for somebody else.

If you’re looking to start an anxiety medication, your preferences should be top of mind. Ask your healthcare provider about medication effectiveness, side effects you can expect, and how long it’ll take to work. Checking a medication’s price or seeing if it’s covered by your health insurance (if applicable) is also a good idea.

What you should know when starting an anxiety medication

With so many treatment options available for anxiety, it’s important to understand the differences between medications. It’s also helpful to know what to expect when you first start taking them.

Here, we’ll discuss nine things you should know about anxiety medications. This discussion focuses on SSRIs, SNRIs, and benzodiazepines. 

1) What are the most common side effects of each medication?

Side effects can vary by medication and medication class. 

Common side effects of SSRI or SNRI antidepressants include:

• Sexual problems, like lower sex drive or erectile dysfunction (ED)

• Weight gain

• Nausea

• Headache

• Dizziness

• Difficulty sleeping (insomnia)

Common side effects of benzodiazepines include:

• Confusion

• Tiredness

• Headache

• Nausea

• Diarrhea

2) Do anxiety medications have any serious risks or side effects?

Benzodiazepines have the highest risk for side effects out of the available anxiety medications. It’s possible to become dependent on them and build tolerance. Over time, you may need higher doses to experience the same effects.

Anyone can develop tolerance and dependence on benzodiazepines because of the way they work in the brain. And if you develop dependence and stop taking them suddenly, you can experience withdrawal symptoms. These can be severe or life-threatening in some cases. 

To avoid withdrawal symptoms, you should gradually lower your dose if you’ve been taking them for a while. Your healthcare provider can help you with this. 

Because of these potential risks, benzodiazepines aren’t recommended as first-choice medications. 

Suicidal thoughts and behaviors are a serious side effect associated with all antidepressants. You should talk to your healthcare provider right away if you experience any thoughts of self-harm or suicide while taking an antidepressant.

If you or someone you know is having thoughts of suicide, know that you’re not alone and help is available. Call the National Suicide Prevention Lifeline at 988 or text HOME to 741-741 to reach the Crisis Text Line.

3) How long does it take for anxiety medications to start working?

The onset of anti-anxiety medications depends on the medication class. 

Antidepressants may take 1 to 2 weeks to start working, but it can take up to 8 weeks to see their full effects. This time frame can vary, and it may take longer in some cases.

Benzodiazepines work quickly, often within hours or less. A person may experience improvements in their symptoms soon after they’re taken.

4) What if my anxiety medication isn’t working?

If you’re not experiencing a positive response on one medication, you may have to try another or several others before you find one that is right for you.

In some cases, healthcare providers may give you two medications that work differently if you have anxiety. You may also get switched to a new medication if you don’t experience any improvements within 6 weeks or if symptoms don’t fully go away within 12 weeks.

5) Can my anxiety medication cause long-term changes to my brain and personality?

Benzodiazepines may have a long-term impact on your central nervous system (CNS) — your brain and spinal cord. They might change your brain’s reaction time and ability to think. But more studies are needed to confirm these long-term effects. These effects are less likely to happen if you’re taking a benzodiazepine for a short period of time.

The impact of long-term antidepressant use on your brain isn’t well understood. More studies are needed in this area.

While most medications don’t cause long-term changes to your brain function, people with anxiety may have physical changes in their brain. This can affect how they respond to normal situations and their ability to process emotions. Medications and therapy can help with this.

6) Can I drink alcohol with my anxiety medication?

In general, it’s not recommended to drink alcohol while taking an SSRI, SNRI, or benzodiazepine. This is also true for buspirone and hydroxyzine. If you’re looking to drink alcohol, talk to your healthcare provider for more specific advice.

7) Do I have to take my anxiety medication for life?

Not always. It depends on your symptoms and how controlled they become over time.

As mentioned, if you’re taking an antidepressant, it may take a few weeks before your symptoms improve. It’s recommended to keep taking your medication for at least 12 months if you’re benefiting from it. This is meant to help prevent symptoms from getting worse again.

After 12 months or so, you and your healthcare provider may decide to continue the medication or to gradually stop taking it.

8) Are there any vitamins or supplements to help treat anxiety? 

Vitamins and supplements generally don’t have a lot of evidence that say they’re effective for anxiety. Many vitamins and supplements also have potential interactions with prescription anxiety medications.

If you’re interested in starting a new vitamin or supplement while taking a prescription anxiety medication, speak to a pharmacist to make sure it’s a safe combination.

9) Are there ways to treat anxiety other than medications? 

Besides medications, there are different approaches to treating symptoms linked with anxiety. Therapy and lifestyle changes are two helpful options that don’t involve medications.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) teaches different ways to approach fears and certain social situations. This may also include different relaxation exercises to practice at home.

Lifestyle changes

Caffeine, alcohol, and nicotine can all cause or raise your levels of anxiety. It may be helpful to lower your intake of these substances or avoid them altogether to help control symptoms.

How to talk to your doctor about starting an anxiety medication

It can be intimidating to seek help for your mental health. But it’s an important step to take for your overall well-being, and your healthcare provider is here to help. Before you head to your appointment, it's a good idea to have a game plan.

Keep these five tips in mind when you talk to your provider about starting an anxiety medication:

• Communicate clearly. There are several types and symptoms of anxiety. Be as detailed as you can when you’re talking about your experience with anxiety — don’t try to bluff or soften what you’re going through. This will help your provider choose the most appropriate treatment.

• Be honest about your concerns. Your provider doesn’t know what you don’t tell them. Share your treatment goals, whether that’s avoiding a certain side effect or overcoming a specific obstacle.

• Talk about medication costs. There are many ways to save on anxiety medications, but each one still has a price tag. Based on your financial picture and insurance status, be transparent about what you’re willing to spend.

• Discuss other ways to control your anxiety. Therapy and lifestyle changes are often ways to improve anxiety in addition to medication. Ask them about non-medication ways to manage your symptoms.

• Ask about follow-up. Starting a medication isn’t a one-and-done fix. It’s a step in the right direction, but routine check-ins are key to managing anxiety over time.

If you don’t have a healthcare provider or it’s hard for you to access one, telehealth is another option. Many platforms, including GoodRx Care, allow you to talk to a healthcare provider about anxiety medications from your smartphone, tablet, or computer.