Guide to Anti-Anxiety Medications

Reviewed By: Barbara Rexer, DSW, LCSW, LCADC, CCS, ICCS, DRCC

Written By: Sprout Editorial Team

Anxiety affects more than 40 million people in the United States. While the options for treating anxiety have expanded greatly, many of these medications come with side effects. Here is what you need to know about some of the most popular anti-anxiety medications.

This list of anti-anxiety meds includes those most commonly prescribed, as well as experimental treatments. Below, we’ll look at the benefits, potential risks, and alternatives to medication. 

Benzodiazepines

Benzodiazepines, also known as “benzos,” treat anxiety disorders, seizures, insomnia, and alcohol withdrawal symptoms. The most commonly prescribed benzos are Xanax and Valium. Around 12.5% of the U.S. adult population takes benzodiazepines. 

These medications enhance the gamma-aminobutyric (GABA) neurotransmitter in the brain. The GABA neurotransmitter helps to reduce activity in the neurons that cause anxiety. Enhancing it can lead to feelings of relaxation and overall reduced anxiety.  

Although these medications are safe in the short-term, they are highly addictive. This is the largest potential side effect of taking benzos. Many people can develop a physical dependence on them over time. Other side effects include dizziness, light-headedness, slurred speech, and memory problems. 

List of Benzodiazepines:

• Valium (Diazepam)
• Xanax (Alprazolam)
• Ativan (Lorazepam)
• Librium (Chlordiazepoxide)
• Klonopin (Clonazepam)
• Gapabentin

SSRIs

Another popular prescription among the list of anti-anxiety medications is SSRIs.These medications are often prescribed to treat disorders like PTSD, depression, and bipolar disorder. Some of the most well-known SSRIs are Prozac and Zoloft. 

SSRIs work a lot like benzos in the fact that they impact the serotonin levels in your brain. An SSRI helps you absorb serotonin into your bloodstream, which makes it more accessible to your brain for use. 

SSRIs have been known to make people agitated or more anxious upon taking them. They can also cause nausea, dry mouth, and loss of appetite. These medications also interact with others in dangerous ways. Mixing an SSRI with aspirin, for example, can increase your risk of bleeding. Some individuals experience no side effects, while others experience multiple at once. 

List of SSRIs:

• Celexa (Citalopram)
• Desyrel (Trazodone)
• Lexapro (Escitalopram)
• Prozac (Fluoxetine)
• Zoloft (Sertraline)
• Paxil (Paroxetine)

SNRIs

Not to be confused with SSRIs above, SNRIs are typically used to treat depression. However, they can also be used in patients with anxiety. Like the two medications listed above, SNRIs impact the serotonin levels in your body. They also affect norepinephrine levels. Commonly prescribed SNRIs include Cymbalta and Effexor. 

SNRIs work by blocking serotonin and norepinephrine from re-entering the cells they came from. This helps increase the levels of these two chemicals in the brain, decreasing depression and anxiety. 

Possible side effects of SNRIs include nausea, loss of appetite, high blood pressure, heart palpitations, excessive sweating, constipation, and agitation. Small differences in the disorder being treated or other medications may impact the side effects patients experience. 

List of SNRIs:

• Cymbalta (Duloxetine)
• Strattera (Atomoxetine)
• Pristiq (Desvenlafaxine)
• Effexor XR (Venlafaxine)

Beta Blockers

Doctors typically prescribe beta blockers for heart issues, but some also use them to treat anxiety disorders. Inderal and Tenormin are two brands that are frequently prescribed to help treat anxiety. 

These medications are good at helping to regulate blood pressure and heartbeat. Beta blockers help prevent adrenaline, a stress-related hormone. By preventing an adrenaline rush going to your brain, they can help manage anxiety levels as well. While they won’t combat anxiety directly, they will ease anxiety-related symptoms like fast heart rate, sweating, and dizziness. 

As with any medication, there are potential side effects to taking beta blockers. The risk of experiencing these is especially high when you first begin taking the drug. Common side effects include fatigue, cold hands or feet, shortness of breath, dizziness, and headache.

Beta Blockers for Anxiety:

• Inderal (Propranolol)
• Tenormin (Atenolol)
• Lopressor (Metoprolol)

MAOIs

Monoamine oxidase inhibitors (MAOIs) were one of the first class of drugs introduced to treat depression. Today, doctors more often prescribe them to treat anxiety, although less frequently than the medications listed above. The most well-known MAOIs include Marplan, Parnate, and Nardil. 

MAOIs can help manage the serotonin, dopamine, and norepinephrine levels in the body simultaneously. Monoamine oxidase, which the body produces naturally, blocks these chemicals from entering the brain, causing depression and anxiety. Using an MAOI helps allow more serotonin, dopamine, and norepinephrine to stay in the brain and elevate your overall mood. 

A huge concern for people taking MAOIs is heart problems. You should avoid a number of foods while taking an MAOI, including salami, soy sauces, and some cheeses. If your doctor starts you out on an MAOI, be sure to get a list of these foods. Other common side effects include fever, rapid heartbeat, dilated pupils, and occasional unconsciousness. Despite the many side effects, MAOIs are still the best option for some people, but it pays to ask about the risks and potential alternatives.  

List of MAOIs:

• Marplan (Isocarboxazid)
• Nardil (Phenelzine)
• Emsam (Selegiline)
• Parnate (Tranylcypromine)

Buspirone

Buspirone is another popular anti-anxiety medication. Although sometimes prescribed for other reasons, it is typically used to treat short and long-term anxiety disorders. The most commonly prescribed brand is BuSpar.  Like other anti-anxiety medications, buspirone impacts the levels of serotonin in your brain. It also has an effect on the dopamine levels. 

Common side effects of the drug include mood swings, confusion, headache, nausea, diarrhea, fatigue, and increased sweating. Other serious side effects, such as irregular heartbeat and rash, can also occur. 

Experimental Drugs

In addition to commonly prescribed anti anxiety meds, there are also a number of experimental drugs emerging to treat anxiety. Below, we’ll look at some of these drugs and examine why some doctors are exploring them. We’ll also look at potential risks.  

Ketamine

For patients with treatment-resistant disorders, some doctors have begun to consider ketamine, a dissociative anesthetic and street drug commonly associated with rave culture. Doctors who advocate it refer to studies, such as this one in Yale Medicine, that show it can help the brain make and rebuild connections, which can lead to a longer-lasting impact than current prescription medications such as Xanax. Those who oppose its use point to the potential for abuse. 

Doctors are still doing additional research to see who might benefit from ketamine treatments, but it’s important to note the risks. Misuse can lead to impaired memory, delirium, high blood pressure, sensory detachment, and in high doses, fatal respiratory depression. Because of these risks, it’s important to work closely with your doctor if prescribed ketamine. 

Eye Movement Desensitization and Reprocessing (EMDR) 

EMDR, eye movement desensitization and reprocessing, is another experimental treatment doctors are looking into to help patients with anxiety. It is a psychotherapy treatment designed to help people deal with the anxiety they may have associated with traumatic events or memories. Successful therapy lowers anxiety and resolves negative beliefs. 

Unlike drug-based treatments such as ketamine, the side effects of EMDR are mild. For people who have experienced trauma, the treatment can be stressful in the beginning because of the intensity, but this often subsides. It can also cause light-headedness. It’s also important to know that it doesn’t work for everyone. 

Neuropeptide-Y (NPY)

Researchers are also working on an anti-stress hormone called neuropeptide-Y (NPY) that seems to have a lasting impact on anxiety. The initial effects of NPY exposure are short-lived; however, prolonged exposure can lead to lowered anxiety for weeks or even months at a time. 

William Colmers, a pharmacology professor at the University of Alberta, explained how it works to Medical Express by referring to an imbalance in our fight-or-flight response. When our bodies overreact to stress, he said, we exhaust ourselves of hormones that we need to regulate mood. “Your resources become depleted,” he said. “It’s like gunning your engine to take off, but if you don’t stop, you’ll run out of gas at some point.” NPY acts as a brake on the stress response. 

The drug is still very much experimental and has not yet been approved by the FDA. As new research emerges, potential use cases and risks will become more apparent. 

Anti Anxiety Meds: The Bottom Line

There are a number of treatment options available to individuals suffering from anxiety. However, you do not have to manage your anxiety alone. Working with a medical professional to find the right treatment for you can make a world of difference to your mental health. 

In addition to the treatments mentioned above, there are also a number of natural methods to control the side effects of anxiety. Many people find it is easier to manage anxiety when they regularly exercise, participate in yoga or meditation, among other activities. Talk to your doctor about what you can do to help ease your anxiety.

Written By: Sprout Editorial Team

The Sprout Health Group editorial team is passionate about addiction treatment, recovery and mental health issues. Every article is expert-reviewed.