Are there over-the-counter Xanax alternatives?

Xanax is the brand name of the benzodiazepine alprazolam. It is a controlled substance that doctors commonly prescribe to treat anxiety and panic disorders.

The Food and Drug Administration (FDA) has approved the drug for treating generalized anxiety and panic disorders. But doctors also prescribe the drug to manage other conditions, such as insomnia, seizures, and alcohol withdrawal.

There are several drugs, natural remedies, and therapies that can provide an alternative to Xanax. This article discusses these alternatives.

Xanax alternatives

Xanax can cause side effects like liver dizziness, drowsiness, and weight change. People should only take Xanax as prescribed by a medical professional to mitigate addiction risk.

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

Prescribed medications

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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)

OTC alternatives

You may also consider some OTC alternatives to Xanax to help manage your anxiety symptoms. People can take OTC medications to address certain anxiety symptoms, such as stress, sleep issues, and mood changes. These include:

• 5-Hydroxytryptophan (5-HTP): 5-HTP is a supplement that helps increase serotonin levels. Serotonin is a chemical in our bodies that help regulate our moods. A 2021 study notes that while 5-HTP showed a moderate reduction in anxiety symptoms, the supplement could also aggravate anxiety as a side effect.  
• 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.
• Inositol: Inositol supplements can help decrease anxiety symptoms, such as shortness of breath, dizziness, and a tingling sensation.
• Cannabidiol (CBD): Research has shown the effects of CBD in reducing anxiety symptoms.

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

Natural remedies

You can also consider natural remedies to help manage your symptoms of anxiety. Be sure to talk with your doctor first before taking any of the following:

• Green tea: Green tea contains the amino acid L-theanine, which can help reduce anxiety and acute stress. 
• 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. 
• Valerian root: Valerian root can improve sleep quality, according to a 2019 study. 
• Holy basil: Holy basil reduces symptoms of anxiety, according to research.
• Ashwagandha: Ashwagandha is a herbal supplement that may help reduce stress and anxiety.

Therapy

Therapy is a standard treatment for anxiety. It includes:

• 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. 

Contacting a doctor

Do not hesitate to talk with your doctor if you experience adverse effects from taking these alternatives to Xanax, or don’t see relief or effective management of your symptoms.

Summary

Xanax is the brand name of the drug alprazolam. Doctors commonly prescribe it to treat anxiety and panic disorders.

It is a controlled substance, which means it carries a high risk of misuse that can result in dependence and addiction.

You and your doctor may consider alternatives to Xanax to manage symptoms of depression. These alternatives include prescribed medications, OTC options, natural remedies, and therapy. 

Talk with your doctor before taking any of these alternatives, and if you experience any adverse effects or don’t see your symptoms improving.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.