Antidepressants for anxiety: 7 options

Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP on January 31, 2023

Antidepressants are first-line treatments for anxiety. Other drugs used to treat anxiety include anti-anxiety medications, such as benzodiazepines and beta-blockers.

The most common antidepressants for anxiety are selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs). Tricyclic antidepressants are another option. Many antidepressants are available as both generic and brand name drugs

Antidepressants work by increasing mood-related neurotransmitters in the brain. Doctors often prescribe them for anxiety along with talk therapy.

People with mild anxiety may not need medical treatment. But if your symptoms are causing distress or complications, such as impairing your relationships or leading to alcohol misuse, a doctor may recommend talk therapy, medications, or both to help you manage your symptoms.

Citalopram

Citalopram is an SSRI sold under the brand name Celexa. People take citalopram once daily by mouth as either a tablet or liquid.

Like other antidepressants, citalopram helps boost your mood. You may feel less anxious, sleep better, and feel more relaxed about things that typically worry you.

Side effects

Like all antidepressants, citalopram has a number of possible side effects, which include:

• gastrointestinal symptoms, such as nausea, constipation, or stomach pain
• reduced appetite
• weight loss
• sleep problems
• sweating
• thirst
• fatigue, drowsiness, or yawning
• muscle or joint pain
• dry mouth
• sexual problems
• heavy menstrual periods

Escitalopram

Escitalopram is also known by its brand name Lexapro. The drug is in the SSRI class. People typically take Lexapro in tablet or liquid form once a day, in the morning or evening.

Side effects

You may experience these side effects while taking escitalopram:

• gastrointestinal symptoms
• reduced appetite
• weight loss
• sleep problems
• sweating
• fatigue, drowsiness, or yawning
• dry mouth
• shaking
• sexual problems
• flu-like symptoms
• runny nose
• sneezing

Trazodone

Trazodone is a serotonin modulator. This drug works by increasing the amount of serotonin in the brain. The immediate-release form is only available as a generic in the United States. The extended-release formulation is sold under the brand name Oleptro.

People take this medication in tablet form once a day.

Side effects

The following are some of the more common side effects of trazodone:

• gastrointestinal symptoms
• changes in weight or appetite
• nightmares
• nervousness
• weakness
• fatigue
• stuffy nose
• muscle pain
• dry mouth
• sexual problems
• shaking
• dizziness or lightheadedness
• red or itchy eyes

Sertraline

Zoloft is the brand name for sertraline, an SSRI antidepressant. People typically take this medication once a day.

You can take Zoloft in a tablet or liquid form. If you take the liquid, you must dilute the concentrate before drinking, according to the prescription directions.

Side effects

There are many common side effects of sertraline, which include:

• gastrointestinal symptoms
• sleep problems
• fatigue
• headache
• nervousness
• shaking
• sweating
• sexual problems
• dry mouth
• loss of appetite
• weight changes

Fluoxetine

Fluoxetine is an SSRI sold under the brand name Prozac. A combination product containing fluoxetine and olanzapine is sold as Symbyax. This medication comes as a tablet, capsule, or liquid, and also has a delayed-release capsule form.

Symbyax is used off-label for anxiety. This means doctors may prescribe it for anxiety even though it isn’t officially approved for treating anxiety.

People typically take the delayed-release form of fluoxetine once a week, while other forms are taken once or twice daily.

Side effects

The common side effects of fluoxetine include:

• nervousness
• sleep changes
• nausea
• diarrhea
• dry mouth
• weakness
• yawning
• memory and concentration problems
• headache
• confusion
• sweating
• unusual dreams
• stuffy nose
• sexual problems
• shaking
• weight loss
• loss of appetite

Bupropion

Bupropion is a type of antidepressant known by its brand names Wellbutrin, Aplenzin, Forfivo, and Zyban. Some people use bupropion off-label for anxiety.

Bupropion works by changing the levels of dopamine and norepinephrine in the brain.

This medication comes in a tablet, extended-release tablet, and sustained-release tablet. Depending on the form of bupropion, your prescription may call for a dose once, twice, three, or four times a day.

Side effects

Bupropion’s common side effects include:

• drowsiness
• sleep problems
• dizziness
• nausea
• vomiting
• dry mouth
• headache
• shaking
• weight loss
• appetite loss
• ringing in the ears
• changes in the sense of taste
• sweating
• constipation
• stomach pain

Venlafaxine

The brand name of the extended-release capsule form of venlafaxine is Effexor XR. The immediate-release tablet form is available only as a generic in the United States. Venlafaxine is an SNRI antidepressant.

You can take the extended-release capsule of venlafaxine once a day or the immediate-release tablet two to three times daily.

Side effects

Venlafaxine has many common side effects, which include:

• gastrointestinal symptoms
• weight or appetite loss
• changes in ability to taste food
• ringing in the ears
• enlarged pupils
• hot flashes
• nightmares
• sore throat or chills
• weakness
• fatigue
• pain, burning, tingling, or numbness in the body
• yawning
• dry mouth
• sexual problems
• shaking
• dizziness

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How to choose the right antidepressant for you

You can work with your doctor to choose an antidepressant. You may have to try different medications before finding the right one. Antidepressants can take several weeks to a month before you begin feeling their effects.

Choosing the right medication involves many factors, like:

• type of anxiety disorder
• side effects
• your overall health and lifestyle
• your preferences

Before stopping a medication, it’s important to speak with your doctor about gradually reducing the dose to avoid withdrawal symptoms.

Other anxiety treatments

In addition to antidepressant medications, your doctor may also recommend the following anxiety treatments:

• Cognitive behavioral therapy can help you find new ways of thinking and reacting to circumstances, so you have less anxiety.
• Exposure therapy can help you confront and learn to manage the source of your anxiety.
• Acceptance and commitment therapy teaches you to use mindfulness and goal-setting to manage anxiety.
• Anti-anxiety medications, such as benzodiazepines, reduce symptoms of anxiety and panic attacks.
• Beta-blockers reduce physical anxiety symptoms, like rapid heartbeat and shaking.

Summary

SSRIs and SNRIs are first-line treatments for anxiety. Choosing the right antidepressant is a choice you can make with your doctor.

Besides antidepressants, you can treat anxiety with talk therapy, beta-blockers, or anti-anxiety medications.