Are there over-the-counter Xanax alternatives?

Key takeaways

• Xanax (alprazolam) is a benzodiazepine approved by the FDA to treat anxiety and panic disorders, but it’s a controlled substance with risks of dependence and addiction.
• Over-the-counter and natural options that may help manage anxiety symptoms include CBD, magnesium, valerian root, ashwagandha, and green tea, though you should talk with a healthcare professional before trying these. Therapy approaches like cognitive behavioral therapy (CBT) and exposure therapy can also help treat anxiety.
• Prescription alternatives to Xanax include SSRIs like escitalopram (Lexapro) and sertraline (Zoloft), SNRIs like venlafaxine (Effexor XR), buspirone (BuSpar), and beta-blockers like propranolol (Inderal).

Overview

Xanax is a brand-name medication that doctors commonly prescribe to treat anxiety and panic disorders. It’s a type of medication called a benzodiazepine, which is a controlled substance. Xanax is only available on prescription, so it can’t be bought over the counter (OTC).

However, certain OTC remedies may provide an alternative to Xanax. There are also prescription alternatives if Xanax isn’t right for you.

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Why try Xanax alternatives

Xanax can be an effective treatment for anxiety, but it might not be right for everyone. It can cause side effects like dizziness, drowsiness, and weight change. It also carries a risk of dependence or misuse, so it’s typically not used as a long-term treatment.

You may consider taking alternatives to Xanax if the drug’s side effects affect your quality of life. Alternatives to Xanax include other prescription medications, OTC and natural remedies, and therapy. 

Note: If you have any concerns about misuse or dependence, reach out to a healthcare professional. They can offer judgment-free support to help you.

OTC alternatives to Xanax

Xanax isn’t available OTC, and there are no other benzodiazepines that you can get OTC. This is because they are controlled substances with a high risk of misuse or dependence, so you need to be closely monitored by a doctor throughout your treatment.

In fact, there are no OTC medications available for anxiety. This is because most OTC drugs are for mild, short-term conditions. Anxiety is considered a chronic condition, and most treatments require monitoring from a healthcare professional.

With that said, there are some OTC medications and supplements that may help manage certain symptoms, such as stress, sleep issues, and mood changes, although evidence is often limited on their effectiveness. These include:

• Antihistamines: Antihistamines, such as diphenhydramine (Benadryl), are taken off-label to address short-term sleep problems in people with anxiety. But adults over 65 should not take Benadryl due to an increased risk of falls.
• Probiotics: Research suggests that gut health, which probiotics help promote, contributes to our mental health.
• Kava kava: Kava kava is a plant with potential stress-reducing and calming properties. 
• Magnesium: Magnesium is a mineral that may help reduce anxiety symptoms and help with sleep. 
• Valerian root: Valerian root can improve sleep quality, according to a 2019 study. 
• Ashwagandha: Ashwagandha is a herbal supplement that may help reduce stress and anxiety.
• Green tea: Green tea contains the amino acid L-theanine, which research suggests can help reduce anxiety and acute stress. 

Remember to talk with a healthcare professional first before taking any of these OTC options to manage your symptoms of anxiety.

Therapy for anxiety

Therapy is a standard treatment for anxiety, and it can be beneficial to use alongside medications. Common forms include:

• Cognitive behavioral therapy (CBT): CBT can help identify and change harmful thought patterns that may result in anxiety symptoms. 
• Talk therapy: Talk therapy can help you understand the root of your anxiety. 
• Exposure therapy: Exposure therapy makes you face what you fear or are anxious about. 

Prescription meds

Xanax is an FDA-approved treatment for anxiety and panic disorders. Other prescription medications for the treatment of anxiety and panic disorders include:

• Beta-blockers: Doctors may prescribe beta-blockers off-label for anxiety. They may help manage the physical symptoms of anxiety. Some beta-blockers include:
  • propranolol (Inderal)
  • metoprolol (Lopressor, Toprol XL)
  • bisoprolol (Zebeta)
• Buspirone (BuSpar): Buspirone is an anxiolytic, and it helps reduce symptoms of anxiety.
• Pregabalin (Lyrica): Pregabalin is an anticonvulsant drug for neuropathic pain and fibromyalgia. Doctors may prescribe it off-label to treat some anxiety symptoms.
• Selective serotonin reuptake inhibitors (SSRIs): SSRIs are a common depression treatment, but can also help treat anxiety symptoms. Some SSRIs include:
  • escitalopram (Lexapro)
  • fluoxetine (Prozac)
  • paroxetine (Paxil)
  • sertraline (Zoloft)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs help treat symptoms of anxiety. Some SNRIs include:
  • venlafaxine (Effexor XR)
  • desvenlafaxine (Khedezla, Pristiq)
  • duloxetine (Irenka, Cymbalta)
  • milnacipran (Savella)
• Tricyclics: Doctors most commonly prescribe tricyclics to treat depression, but they may recommend them to treat insomnia and anxiety. They are not as common in depression or anxiety treatments as SSRIs and SNRIs. Some tricyclics include:
  • amitriptyline (Elavil)
  • doxepin (Sinequan)
  • nortriptyline (Pamelor)

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Online care for anxiety

When you have anxiety, many things can feel overwhelming. However, there are treatments available, both prescription and OTC, and there are people out there who can help you.

Online care services, including Optum Perks Online Care, may make getting treatment easier. With these services, you can submit an online form answering a few questions about your symptoms, and a US-licensed healthcare professional will respond soon after to prescribe a treatment plan.

Next steps

If you’re experiencing anxiety, there are many different treatments out there. Xanax is common, but it’s prescription-only and carries some risks. If you want to look into alternatives, the next steps to consider include:

• Make an appointment with a healthcare professional, either in person or online.
• Try OTC or natural options to see if they soothe your symptoms.
• Look into therapy options.
• Most importantly, know you’re not alone — there are people out there who can help you.

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