A GoodRx Savings Guide to 10 Mental Health Medications Used for Depression and Anxiety

Major depressive disorder (MDD, or simply “depression”) and generalized anxiety disorder (GAD, or “anxiety”) are two of the most common mental health conditions. And it’s also common for people to have both conditions at the same time. For many people, medications are an important part of managing symptoms.

But when it comes to mental health medications, there are dozens of potential options. Each has unique uses, risks, and costs. At GoodRx, we believe that everyone should be able to afford their medications. Here, we’ll review some of the most effective mental health medications used for depression and anxiety, along with ways to save on each.

1. Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are some of the most prescribed mental health medications — and for good reason. Many are effective for both depression and anxiety. And they’re all available as lower-cost generic medications.

SSRIs work by blocking the reuptake (reabsorption) of serotonin. This raises levels of it in the brain. Serotonin is a neurotransmitter (chemical messenger) that’s involved in regulating mood, digestion, and various other bodily functions.

SSRIs may also raise levels of a protein called brain-derived neurotrophic factor (BDNF). This protein helps neurons (nerve cells) in the brain communicate effectively. Higher levels of BDNF are believed to help alleviate symptoms of depression.

Common side effects of SSRIs include nausea, headache, and sleep changes. These are especially prominent when someone first starts an SSRI or raises their dosage. They typically improve with time or are easily managed at home. SSRIs can also cause weight gain and sexual side effects, such as erectile dysfunction or low libido. But the specific risk for these side effects varies between individual SSRIs.

How to save on SSRIs

SSRIs are all available as lower-cost generics. GoodRx can help you save on the average retail price of these medications. You can find SSRI prices for as low as about $5 per month with a free GoodRx discount.

There are additional ways to save on brand-name SSRIs:

• Prozac: If you’re uninsured or underinsured, you may be eligible for Prozac’s patient assistance program, which offers the medication at no charge.

• Viibryd: If you have commercial insurance and meet eligibility requirements, Viibryd’s price may be as low as $15 for a 30- or 90-day supply if you use the manufacturer’s savings card. If you’re uninsured or underinsured, you may be eligible for Viibryd’s patient assistance program, which offers the medication at no charge.

• Zoloft: If you have commercial insurance and meet eligibility requirements, Zoloft’s price may be as low as $4 per month if you use the manufacturer’s savings card.

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2. Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another popular class of mental health medications. Most SNRIs are FDA approved for depression, but some are also approved for anxiety disorders. Beyond being helpful for mental health conditions, many SNRIs can also help with certain chronic pain conditions. Most are available as lower-cost generics, making them similarly affordable to some SSRIs.

SNRIs work a bit differently than SSRIs. SNRIs also boost levels of serotonin in the brain. But they also prevent the reuptake of another neurotransmitter called norepinephrine. Experts believe norepinephrine plays a role in regulating mood, focus, and the perception of pain. And like SSRIs, SNRIs also likely raise levels of BDNF.

SNRIs have similar side effects to SSRIs. Common ones include nausea, upset stomach, and sleeping changes. Sexual side effects are also possible. But as a class, it seems like SNRIs may cause less weight gain than SSRIs.

How to save on SNRIs

Most SNRIs are all available as lower-cost generics. GoodRx can help you save on the average retail price of these medications. You can find SNRI prices for as low as about $13 per month with a free GoodRx discount.

There are additional ways to save on brand-name SNRIs:

• Cymbalta: If you’re uninsured or underinsured, you may be eligible for Cymbalta’s patient assistance program, which offers the medication free of charge.

• Effexor XR: If you have commercial insurance and meet eligibility requirements, Effexor XR’s price may be as low as $4 per month if you use the manufacturer’s savings card.

• Fetzima: If you have commercial insurance and meet eligibility requirements, Fetzima’s price may be as low as $10 for a 30- or 90-day supply if you use the manufacturer’s savings card. If you’re uninsured or underinsured, you may be eligible for Fetzima’s patient assistance program, which offers the medication at no charge.

• Pristiq: If you have commercial insurance and meet eligibility requirements, Pristiq’s price may be as low as $4 per month if you use the manufacturer’s savings card.

3. Atypical antidepressants, such as bupropion

“Atypical antidepressants” isn’t technically a class of medications. It’s a catch-all name for antidepressants that work differently from others. They include several different medications that can treat depression, anxiety, and/or other mental health conditions. Of these, bupropion and trazodone are two of the most prescribed. However, Auvelity is notable due to how fast it works.

Bupropion works by blocking the reuptake of norepinephrine and dopamine in the brain. Dopamine is a neurotransmitter that’s involved in mood regulation, motivation, and pleasure. It’s less likely than other antidepressants to cause weight gain and sexual side effects. But it’s not recommended for people with a history of seizures or eating disorders.

Trazodone’s mechanism of action isn’t fully understood. Similar to SSRIs, it prevents reuptake of serotonin. But it also blocks serotonin, histamine, and alpha-1-adrenergic receptors (binding sites). Although trazodone is only FDA approved for MDD, it’s often prescribed off-label for insomnia and anxiety. Common side effects include drowsiness, dry mouth, and blurry vision.

Auvelity is one of the newest mental health medications. It’s known for how fast it starts working. Most antidepressants take 4 to 8 weeks to start working. Auvelity may begin providing symptom improvement in 1 to 2 weeks. Its side effects are similar to that of bupropion.

Auvelity is also notable for how it works. It combines dextromethorphan and bupropion. Dextromethorphan blocks N-methyl-D-aspartate (NMDA) receptors while activating sigma-1 receptors at the same time. This raises levels of the neurotransmitters glutamate and monoamine, which play a role in mood regulation. The bupropion component, beyond the actions discussed above, helps prevent the body from metabolizing (breaking down) dextromethorphan too quickly.

How to save on atypical antidepressants

Many atypical antidepressants are available as lower-cost generics. GoodRx can help you save on the average retail price of these medications. You can find atypical antidepressant prices for as low as about $9 per month with a free GoodRx discount.

There are additional ways to save on brand-name atypical antidepressants:

• Aplenzin: If you have commercial insurance and meet eligibility requirements, Aplenzin’s price may be as low as $5 per month if you use the manufacturer’s savings card.

• Auvelity: If you have commercial insurance and meet eligibility requirements, Auvelity’s price may be as low as $10 for a 30- or 90-day supply if you use the manufacturer’s savings card.

• Forfivo XL: If you have commercial insurance and meet eligibility requirements, Forfivo XL’s price may be as low as $28 per prescription if you use the manufacturer’s savings card.

• Trintellix: If you have commercial insurance and meet eligibility requirements, Trintellix’s price may be as low as $10 for a 30- or 90-day supply if you use the manufacturer’s savings card. If you’re uninsured or underinsured, you may be eligible for Trintellix’s patient assistance program, which offers the medication at no charge.

• Wellbutrin XL: If you have commercial insurance and meet eligibility requirements, Wellbutrin XL’s price may be as low as $5 per month if you use the manufacturer’s savings card.

4. Atypical antipsychotics, such as olanzapine

Atypical (second-generation) antipsychotics are a class of mental health medications most often associated with schizophrenia and bipolar disorder. But they can also be a helpful addition when it comes to treatment-resistant depression. It’s recommended to add an atypical antipsychotic to existing medications when used for this condition. They shouldn’t be prescribed by themselves in most cases.

Atypical antipsychotics primarily work by blocking dopamine receptors. But they also impact certain 5-HT (serotonin) receptors. This can help boost the activity of SSRIs. Certain atypical antipsychotics also raise or regulate levels of other neurotransmitters, including norepinephrine and glutamate.

Atypical antipsychotics can cause side effects such as sleep changes, dry mouth, and sexual problems. Extrapyramidal symptoms (movement issues) are also possible. Notably, many atypical antipsychotics can lead to metabolic side effects, such as weight gain and raised blood glucose (sugar). Of those that are FDA approved for treatment-resistant depression, aripiprazole and cariprazine have lower risks for metabolic side effects.

Good to know: Symbyax (olanzapine / fluoxetine) is a convenient combination pill for treatment-resistant depression. It contains an SSRI and an atypical antipsychotic. It can help reduce the number of pills a person needs to take every day.

How to save on atypical antipsychotics

Many atypical antipsychotics are available as lower-cost generics. GoodRx can help you save on the average retail price of these medications. You can find atypical antipsychotic prices for as low as about $11 per month with a free GoodRx discount.

There are additional ways to save on brand-name atypical antipsychotics:

• Abilify: If you have commercial insurance and meet eligibility requirements, Abilify’s price may be as low as $5 per month if you use the manufacturer’s savings card.

• Rexulti: If you have commercial insurance and meet eligibility requirements, Rexulti’s copay card may lower the cost to $0 per month for the first 2 months. After that, the price may be as low as $5 per month. If you’re uninsured or underinsured, you may be eligible for Rexulti’s patient assistance program, which offers the medication at no charge.

• Vraylar: If you have commercial insurance and meet eligibility requirements, Vraylar’s copay card may lower the cost to $0 per month for the first 2 months. After that, the price may be as low as $5 for a 30-, 60-, or 90-day supply. If you’re uninsured or underinsured, you may be eligible for Vraylar’s patient assistance program, which offers the medication at no charge.

5. Buspirone

Buspirone is a mental health medication prescribed for anxiety disorders. It’s unique from other anxiety medications, and the way it works still isn’t fully understood. Experts believe it may bind to certain serotonin receptors and help regulate the neurotransmitter’s activity in the brain. It may also impact dopamine’s activity.

Buspirone isn’t usually considered a first-choice medication for anxiety disorders. It’s recommended to try SSRIs or SNRIs first. Adding buspirone to one of these other medications may provide added benefit. Buspirone can also be helpful if a person is experiencing sexual side effects from an SSRI or SNRI.

Buspirone doesn’t start working right away. It may take 2 to 4 weeks for people to notice initial effects. Common side effects include dizziness, nausea, and headache. Less commonly, people have reported mild extrapyramidal symptoms, such as restlessness or tremors.

How to save on buspirone

Buspirone is available as a lower-cost generic. GoodRx can help you save over 75% off the average retail price. Buspirone’s price at certain pharmacies is as low as $8.74 with a free GoodRx coupon.

6. Hydroxyzine

Hydroxyzine (Vistaril) is another unique anxiety medication. It’s an antihistamine. But unlike others in its class, hydroxyzine blocks histamine’s activity and raises serotonin levels. This can help relieve symptoms of anxiety. Hydroxyzine comes in two forms — hydroxyzine hydrochloride and hydroxyzine pamoate — which work similarly.

Hydroxyzine starts working quickly — usually within 30 minutes. This can make it helpful for managing panic or anxiety attacks. And unlike benzodiazepines (covered next), hydroxyzine doesn’t carry a risk of dependence or misuse. However, it’s not considered a first-choice anxiety medication. This is because other options, such as SSRIs and SNRIs, are typically more effective and cause less side effects than hydroxyzine.

Hydroxyzine’s side effects include drowsiness, dry mouth, and constipation. It’s recommended that adults ages 65 and older avoid hydroxyzine, since it can raise the risk of falls. Very rarely, this medication can also cause an abnormal heart rhythm called QT prolongation. So it’s best avoided if people have a higher risk for this or take other medications that raise the risk.

How to save on hydroxyzine

Hydroxyzine is available as a lower-cost generic medication. GoodRx can help you save over 60% off the average retail price. Hydroxyzine hydrochloride’s price at certain pharmacies is as low as $5.41 with a free GoodRx discount. Hydroxyzine pamoate’s price at certain pharmacies is as low as $8.54 with a free GoodRx discount.

7. Benzodiazepines

Benzodiazepines (BZDs) are a well-known class of mental health medications used for anxiety. Common medications in this class include:

• Alprazolam (Xanax)

• Clonazepam (Klonopin)

• Diazepam (Valium)

• Lorazepam (Ativan)

BZDs work by enhancing the effects of gamma-aminobutyric acid (GABA). It does that by binding to certain GABA receptors. This leads to feelings of calm and drowsiness.

You can expect BZDs to start working quickly (in an hour or less). This means they can be helpful for panic attacks. But expert guidelines recommended only using them for short periods of time. This is because the body builds up tolerance with extended use of these medications. And withdrawal symptoms can occur if a person suddenly stops their benzodiazepine after taking it for a while.

Common BZD side effects include drowsiness, dizziness, and coordination problems. Similar to hydroxyzine, it’s recommended that adults 65 and older avoid BZDs since they can raise the risk of falls. Serious side effects include a risk of dependence or misuse and overdose.

If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.

8. Spravato

Esketamine (Spravato) is a newer antidepressant option. It’s FDA approved for treatment-resistant depression and MDD with suicidal ideation or behavior. Unlike the other mental health medications listed above, a person must administer their doses of esketamine under the supervision of a medical professional.

How esketamine works isn’t completely understood, but we know it’s an NMDA receptor antagonist. This action causes higher levels of glutamate. But it likely works in other areas of the brain, too. Esketamine is the fastest-acting antidepressant on this list. It can start relieving symptoms within 2 to 4 hours of administering a dose.

Common esketamine side effects include drowsiness, nausea or vomiting, and dissociation. Dizziness, altered taste, and temporary increases in blood pressure are also frequently reported. Rarely, esketamine can cause respiratory depression and worsening depression. It also has a risk for dependence and misuse. These serious risks are why it must be administered at a healthcare professional’s office or clinic.

How to save on Spravato

There are ways to save on Spravato, which is only available as a brand-name medication. If you have commercial insurance, you may be eligible to pay as little as $10 for each Spravato treatment session using a savings card from the manufacturer. If you’re uninsured or underinsured, you may be eligible for Spravato’s patient assistance program, which offers the medication free of cost.

Keep in mind that Spravato is administered at a healthcare professional’s office. It’s not dispensed directly to the person using it at a pharmacy. Because of this, it may be covered by your medical insurance plan (not your prescription drug insurance plan).

9. Tricyclic antidepressants, such as amitriptyline

Tricyclic antidepressants (TCAs) are an older class of antidepressants. They’re not often prescribed for depression due to their side effects. But they’re still an option for treatment-resistant depression or if people can’t take other medications. And they may be helpful if a person also has insomnia, nerve pain, or migraines.

Of the TCAs, amitriptyline is the most prescribed. TCAs work for depression by preventing the reuptake of serotonin and norepinephrine. But they also bind to alpha, muscarinic, and histamine receptors. Their activity at these other receptors contribute to their side effect profile.

TCAs are generally less tolerated than SSRIs or SNRIs. They tend to cause a lot of anticholinergic side effects, such as dry mouth, constipation, and blurred vision. They can raise the risk of falls for older adults and aren’t recommended for people 65 or older. Very rarely, TCAs can cause urinary retention and QT prolongation.

How to save on TCAs

All TCAs are all available as lower-cost generics. GoodRx can help you save on the average retail price of these medications. You can find TCA prices for as low as about $6 per month with a free GoodRx discount.

10. Monoamine oxidase inhibitors (MAOIs)

Monoamine oxidase inhibitors (MAOIs) were the first class of antidepressants to be developed. They’re rarely prescribed for MDD anymore due to their side effects, drug interactions, and dietary restrictions. But they can be effective for treatment-resistant depression.

MAOIs work by inhibiting the enzyme MAO. This enzyme plays a role in metabolizing serotonin, norepinephrine, and dopamine, among other neurotransmitters. MAOIs increase levels of these neurotransmitters by blocking their breakdown.

But MAO also helps metabolize the amino acid tyramine. So MAOIs can also raise levels of this substance. Too much tyramine can lead to serious complications, including a hypertensive crisis. Because of this, people taking MAOIs typically need to be careful about how much tyramine they consume. This is often referred to as the “MAOI diet.”

MAOIs also have a number of other side effects. Most commonly, people experience dry mouth, drowsiness, and nausea. Dizziness and constipation are also possible. MAOIs have a number of severe drug interactions to keep in mind, too. In particular, they have a higher risk of causing serotonin syndrome when combined with other medications that affect serotonin levels.

How to save on MAOIs

Most MAOIs are all available as lower-cost generics. GoodRx can help you save on the average retail price of these medications. You can find MAOI prices for as low as about $39 per month with a free GoodRx discount.

There are additional ways to save on brand-name MAOIs:

• Emsam: If you have commercial insurance and meet eligibility requirements, Emsam’s price may be as low as $20 for the first month if you use the manufacturer’s savings card. After that, you can save up to $600 off for each 30-day refill.

• Marplan: If you have commercial insurance and meet eligibility requirements, Marplan’s price may be as low as $20 per month if you use the manufacturer’s savings card. With this card, there’s a maximum savings of $100 for a 30-day supply, $150 for a 60-day supply, and $200 for a 90-day supply.

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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