A guide to starting anxiety medication

Anxiety involves a range of psychological and physical effects, including persistent worry and stress, a racing heart, and sweaty palms.

It’s natural to experience anxiety occasionally, but if it’s beginning to affect your life or lasts for a long time, you should consider speaking with a healthcare professional.

If you have an anxiety disorder, such as generalized anxiety disorder (GAD) or social anxiety disorder (SAD), you might consider starting anxiety medication. Different types of medications have different effects and side effects.

Types of anxiety medications

Healthcare professionals might prescribe you several types of medication to treat anxiety. These are three of the most common treatment options.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are a kind of antidepressant. They increase the levels of serotonin in your brain, which can help regulate your mood.

According to the National Institutes of Health (NIH), it may take 6 weeks before you notice the full benefits of SSRIs. If you don’t see any improvement after this time, a healthcare professional may decide to increase your dose. Research finds that higher SSRI doses show more significant symptom improvements.

Common examples of SSRIs for anxiety include:

• sertraline (Zoloft)
• fluoxetine (Prozac)
• escitalopram (Lexapro)
• paroxetine (Paxil)

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Serotonin and norepinephrine reuptake inhibitors (SNRIs)

SNRIs are another form of antidepressants that you can take to treat anxiety. They increase the levels of serotonin and norepinephrine in the brain, which also help regulate mood and behavior.

SNRIs can get to work quite quickly. The National Alliance on Mental Illness states that SSRIs can get to work within 2 weeks, although —similar to SSRIs — you should wait up to 2 months to see the full benefits.

But at higher doses of SNRIs, their tolerability sometimes lowers as side effects become worse. You can have a discussion with a healthcare professional about the risks and benefits of using SNRIs versus SSRIs and your dosing schedule.

Examples of SNRIs include:

• duloxetine (Cymbalta)
• venlafaxine (Effexor)
• desvenlafaxine (Pristiq)

Benzodiazepines

Benzodiazepines are a class of medication that affects your central nervous system. They can help provide a calming effect on your body.

Research suggests that benzodiazepines are very effective for relieving anxiety symptoms in GAD, and the researchers recommended combined treatment with antidepressants and benzodiazepines due to the differences in how they work.

Benzodiazepines are known for working quickly and are best used to provide short-term relief from symptoms at a low dose, while antidepressant medications are best for long-term usage.

Please note that because benzodiazepines are quick-acting, they have a high risk of becoming misused, leading to dependency. If you feel this is a concern for you, reach out to a healthcare professional, who can provide the support you need.

Examples include:

• alprazolam (Xanax)
• lorazepam (Ativan)
• diazepam (Valium)

Side effects

While all of these medications are effective in treating anxiety, they can all have side effects.

SSRIs

Some of the most common SSRI side effects include:

• nausea and vomiting
• changes in sexual function
• confusion
• dizziness or lightheadedness

Because of their effect on serotonin levels, in rare cases, SSRIs can lead to a condition called serotonin syndrome, which is a reaction to having too much serotonin in your body.

If you stop taking SSRIs suddenly, you might experience withdrawal symptoms that may feel flu-like in nature and a return of your symptoms. If you want to stop taking SSRIs, you should speak with a healthcare professional who can help you do so safely.

SNRIs

The possible side effects of SNRIs are similar to those of SSRIs and include:

• stomach symptoms such as pain, constipation, and diarrhea
• sex drive changes
• appetite loss and weight loss
• dizziness and headaches

They also increase the risk of serotonin syndrome and can lead to withdrawal symptoms if you stop taking them suddenly.

Note that with antidepressants, suicidal thoughts and behaviors can arise in young people. If you feel that this is affecting you, please reach out to someone close to you for support and seek emergency medical treatment.

If you or someone you know is considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline 24 hours a day at 988.
• Text “HOME” to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency number if you feel it’s an emergency.

While you wait for help to arrive, stay with someone and remove any weapons or substances that can cause harm. You are not alone.

Benzodiazepines

The most common concern with benzodiazepines is that they can be habit-forming and difficult to stop taking. This is why healthcare professionals typically recommend you take them short term. A long-term regimen could cause serious withdrawal symptoms that can be life threatening.

If you have a previous history of substance misuse or you feel that dependency or addiction is a concern for you, reach out to a healthcare professional. They usually won’t prescribe benzodiazepines in these cases, and you can discuss alternative treatments.

Other common side effects include:

• fatigue (low energy)
• dizziness
• confusion
• slowed reaction time
• decreased libido

Other treatments

If you have an anxiety disorder, it’s unlikely that you’ll just be prescribed medications — in most cases, healthcare professionals will also recommend a form of talk therapy, most commonly cognitive behavioral therapy (CBT). Research finds CBT to be effective in treating anxiety disorders such as GAD.

Alongside these medical treatment options, you can try some home remedies to help reduce your symptoms. These include:

• exercise
• stress-reduction methods such as yoga and meditation
• reducing caffeine and alcohol consumption, if applicable

Summary

Anxiety disorders can cause a host of unpleasant symptoms, and they can significantly affect your day-to-day life. If you’re considering starting anxiety medications, there are a few things to keep in mind.

Several different types of anxiety medication — most commonly antidepressants and benzodiazepines — work slightly differently and can have different effects.

Benzodiazepines work more quickly and are more suitable for a short-term regimen, while SSRIs and SNRIs take a few weeks to take effect and are more commonly taken in the long term.

Bear in mind the different side effects, and know that you can combine medications with therapy options and lifestyle measures to help ease your symptoms.

Anxiety can be difficult, but know you don’t need to experience it alone and you can seek treatment to help you feel better.

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