HomeHealth TopicAnxiety Disorders

Starting an Anxiety Medication? Here’s 9 Things You Should Know

Abe Amos, PharmDChristina Aungst, PharmD
Published on October 26, 2021

Key takeaways:

  • Many people experience anxiety and take medication to improve symptoms.

  • Each anxiety medication has unique benefits and possible side effects.

  • It’s recommended to take your anxiety medication as directed by your healthcare provider, even if you don’t feel improvements in your symptoms right away.

Doctor giving a senior man a medicine consultation.
simon2579/E+ via Getty Images

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 talk about things you should know if you’re starting a new anxiety medication.

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. More on this next.

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:

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

Tricyclic antidepressants (TCAs) like amitriptyline (Elavil) and monoamine oxidase inhibitors (MAOIs) like isocarboxazid (Marplan) and phenelzine (Nardil) are also used. But they’re older antidepressants that aren’t as commonly prescribed as SSRIs and SNRIs. However, they may still provide relief, especially if other treatments don’t work.

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 treatments

Although SSRIs, SNRIs, and benzodiazepines are common, 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. This can help prevent symptoms like a fast heartbeat, shaking, and blushing before moments like public speaking.

What are a few key things I need to know about anxiety medications?

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. Buspirone, hydroxyzine, and propranolol are discussed in separate GoodRx articles.

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

Side effects can vary by medication and medication class. But some of them have some general side effects that are common amongst each other.

Common side effects of some SSRI or SNRI antidepressants may include:

  • 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?

Of all the medications described here, benzodiazepines have the highest risk for side effects. It’s possible to become dependent on them and build tolerance to them. Over time, you may need higher doses to experience the same effects.

These effects can happen to anyone. This is because of the way benzodiazepines work in the brain.

Withdrawal symptoms can develop if benzodiazepines are suddenly stopped after being used for a while. To avoid withdrawal symptoms, it’s recommended to gradually lower your dose. Your healthcare provider can help you with this. But because of these potential side effects, benzodiazepines aren’t recommended as first-choice medications. 

Suicidal thoughts and behaviors are a serious side effect associated with antidepressants. You should talk to your healthcare provider right away if you experience this while taking an antidepressant.

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

Antidepressants may take 2 to 6 weeks to start working. 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 also isn’t well understood. More studies are needed.

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?

The specific risks vary by medication. But, 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, please 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 the medication. 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, it’s recommended to speak to a pharmacist to make sure it’s a safe combination.

9) Are there any nonmedication ways to help with anxiety? 

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

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) focuses on working with a person who experiences anxiety. It 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.

The bottom line

Most people will experience anxiety at many points during their life. If anxiety has a significant impact on carrying out normal daily activities, it’s recommended to reach out to your healthcare provider and have a conversation about how to treat your symptoms. Therapy and anxiety medications can both help improve quality of life.

References

Barker, M. J., et al. (2004). Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: A meta-analysis. Archives of Clinical Neuropsychology.

Bounds, C. G., et al. (2021). Benzodiazepines. StatPearls.

View All References (8)

Cartwright, C., et al. (2016). Long-term antidepressant use: Patient perspectives of benefits and adverse effects. Patient Preference and Adherence.

Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2018). What are the parts of the nervous system?

Farach, F. J., et al. (2012). Pharmacological treatment of anxiety disorders: Current treatments and future directions. Journal of Anxiety Disorders.

Locke, A. B., et al. (2015). Diagnosis and management of generalized anxiety disorder and panic disorder in adults. American Family Physician.

National Institute of Mental Health. (2018). Anxiety disorders.

Sarris, J., et al. (2012). Complementary medicine, exercise, meditation, diet, and lifestyle modification for anxiety disorders: A review of current evidence. Evidence-Based Complementary and Alternative Medicine.

Sheffler, Z. M., et al. (2021). Antidepressants. StatPearls.

Stewart, S. A. (2005). The effects of benzodiazepines on cognition. The Journal of Clinical Psychiatry.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

Was this page helpful?

image
Subscribe and save.Get prescription saving tips and more from GoodRx Health. Enter your email to sign up.
By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.

Wordmark logo (w/ dimension values)
GoodRx FacebookGoodRx InstagramGoodRx Twitter
Legitscript ApprovedPharmacyBBB Accredited Business