The 4 Major Classes of Anxiety Medication

Table of ContentsView AllTable of ContentsMedications for AnxietySSRIsSNRIsTCAsBenzodiazepinesAnxiety Medication Risks

Table of ContentsView All

View All

Table of Contents

Medications for Anxiety

SSRIs

SNRIs

TCAs

Benzodiazepines

Anxiety Medication Risks

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What is the most important information I should know about anxiety medications?Be sure to take your medications exactly as prescribed.If you are having serious side effects, consult your healthcare provider.Do not stop your medication without talking to a doctor as this can cause serious health issues.

What is the most important information I should know about anxiety medications?

Be sure to take your medications exactly as prescribed.If you are having serious side effects, consult your healthcare provider.Do not stop your medication without talking to a doctor as this can cause serious health issues.

Anxiety medication can provide relief for people who are experiencing symptoms of anxiety or anxiety disorders. Some anxiety medications can be taken as needed when a person is feeling anxious. In other cases, medications need to be taken regularly in order to provide more lasting relief.

Anxiety disordersare more than just a case of nerves. They are recognized mental health conditions that can make it more difficult to cope with life’s ups and downs—even sometimes making it harder to enjoy or even participate in daily activities.

Fortunately, there are a number of anxiety medications available to treat anxiety disorder symptoms. Learn what these medicines are, how they work, their benefits, and their potential risks.

It can take up to six weeks for anxiety medications to start working. They can be particularly helpful when used along withpsychotherapy.

The Best Online Therapy for Anxiety, Tried and Tested

Medications for Anxiety That Can Help

There are four major classes of medications used in thetreatment of anxiety.Each class attempts toreduce anxietyin a different way and has its own benefits and risks.

While some anxiety medications may be considered preferred options, drug selection can vary based on the type of anxiety you have and your symptoms. The amount of time you are on the drug can vary as well.

For instance, if you take antidepressant medications, your healthcare provider may recommend that you continue to use them for four to nine monthsaftersymptoms have resolved.But if you take benzodiazepines, you should only use them short-term.

Overall, using medications for anxiety disorders is considered safe and effective.

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Selective Serotonin Reuptake Inhibitors (SSRIs)

If you’ve been diagnosed with an anxiety disorder, your doctor may recommend one of the following SSRIs:

Although SSRIs tend to have fewer side effects than some other antidepressants, they may still cause gastrointestinal distress, sleep difficulties, and sexual dysfunction.Many of these effects go away within a couple of weeks of beginning the medication, however. So, give your body time to adjust.

RecapSSRIs are considered the first-line treatment for anxiety disorders and often have fewer adverse effects than other medications.

Recap

SSRIs are considered the first-line treatment for anxiety disorders and often have fewer adverse effects than other medications.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Serotonin-norepinephrine reuptake inhibitors(SNRIs) are another first-line option for treating anxiety.This class of medicines increases levels of both serotonin andnorepinephrine. Like serotonin, norepinephrine is a neurotransmitter in the brain that plays a role in mood regulation.

Some of the SNRIs prescribed for anxiety include:

SNRIs are considered just as effective as SSRIs, but they do tend to have more side effects.Side effects of SNRIs can include headaches, sexual dysfunction, insomnia, upset stomach, and increased blood pressure.

RecapSNRIs are another first-line anxiety medication and are considered as effective as SSRIs, although they can have more side effects.

SNRIs are another first-line anxiety medication and are considered as effective as SSRIs, although they can have more side effects.

Tricyclic Antidepressants (TCAs)

Tricyclic antidepressants(TCAs) were some of the first medications used to treat anxiety disorders.Like SNRIs, TCAs block the reuptake of serotonin and norepinephrine. And they’ve been found effective for treating various anxiety disorders.

The TCAs prescribed for anxiety include:

Although they are just as effective as SSRIs in treating anxiety disorders, TCAs tend to cause significant side effects, including dry mouth, constipation, blurry vision, trouble urinating, and hypotension (low blood pressure on standing).For these reasons, TCAs are usually only prescribed when other drugs don’t provide relief.

RecapTCAs are effective for treating anxiety but often come with more significant side effects, so they are often only prescribed when other anti-anxiety medications aren’t working.

TCAs are effective for treating anxiety but often come with more significant side effects, so they are often only prescribed when other anti-anxiety medications aren’t working.

Benzodiazepines can be taken as needed to help you relax and reduce muscle tension when facing a stressful situation. Because they are fast-acting, they can help treatpanic attacks.They can also be useful forsocial anxiety disorder(SAD) andphobiasif they are only taken occasionally.

Common benzodiazepines include:

Possible side effects include drowsiness, dizziness, impaired coordination, and vision issues.When used on occasion or short term, benzodiazepines have a low risk of addiction. However, they are not considered safe for long-term use as this can increase the risk of dependence and tolerance.

RecapBenzodiazepines can help treat anxiety short-term, on an as-needed basis, but aren’t recommended for long-term use due to an increased risk of dependence.

Benzodiazepines can help treat anxiety short-term, on an as-needed basis, but aren’t recommended for long-term use due to an increased risk of dependence.

Anxiety medications have some important risks you should be aware of. These risks can differ a bit between the drug classes.

Suicidal Thoughts

Suicidal thoughtsare a risk with antidepressants, particularly for younger patients. A review of 24 different studies found that 4% of child or adolescent antidepressant users had a higher risk of suicidality within the first few months of starting these drugs—double the amount of those receiving a placebo.

As a result, in 2004, the Food and Drug Administration (FDA) began to require that all antidepressants carry a black-box warning relating to the increased risk of suicidal thinking and behavior in children and adolescents.

Those younger than 25 should be carefully watched for signs of suicidal thinking, especially at the beginning of treatment or when dosages are changed. This includes experiencing increased depression, agitation, irritability, suicidality, and unusual changes in behavior.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Negative Effects of Antidepressants

Tolerance and Dependence

Dependence is a greater concern with benzodiazepines than some of the other anti-anxiety medication classes. Long-term benzodiazepine use (more than 12 weeks) is generally not recommended because you can develop tolerance and/or dependence.

Tolerancemeans that you need to take more of the medication in order to make it work. Dependence means that you develop withdrawal symptoms if you stop taking the medication.

Research has found that among people who take benzodiazepines for longer than six months, 40% will experience moderate to severe withdrawal symptoms.Talking to your doctor before you stop taking your medication is essential since benzodiazepine withdrawal can be dangerous.

Addiction, Dependence, Tolerance: What’s the Difference?

Potential for Misuse or Abuse

Research published in 2020 found that benzodiazepine misuse occurs in 17% of users.A 2014 study involving 2,700 students in high school and middle school found that the risk of benzodiazepine abuse was 12 times higher in teens who had been prescribed these drugs.

Anxiety Medication Withdrawal

Many people who take medication over a long period of time can become dependent. When they go off the drug, they need to do so gradually to avoid experiencingwithdrawal symptoms.

Antidepressant drug withdrawalcan occur within days of stopping the medication and symptoms generally resolve within a couple of weeks.Ironically, many withdrawal symptoms are similar to anxiety symptoms, including:

Some drugs can cause more severe withdrawal symptoms than others. For instance, discontinuing benzodiazepines after long-term use can lead to severe or life-threatening withdrawal symptoms, such as seizures, delirium, and even death.

Talk with your healthcare provider before discontinuing any medication. To avoid withdrawal symptoms, they may taper your medication dose, reducing it gradually.

Anxiety Medication Interactions

Some anti-anxiety medications negatively interact with other drugs. For example, if benzodiazepines are taken in combination with anopioid medication, it can result in difficult or slowed breathing and death.

Tell your healthcare provider if you are taking any other medications. Abstaining from alcohol when taking benzodiazepines is also important because the interaction between these drugs and alcohol can lead to serious, possibly life-threatening complications.

23 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialog Clin Neurosci. 2017;19(2):doi:10.31887/DCNS.2017.19.2/bbandelowAnxiety & Depression Association of America.Medication options.American Psychological Association.How hard is it to stop antidepressants?Garakani A, Murrough J, Freire R, et al.Pharmacotherapy of anxiety disorders: Current emerging treatment options.Front Psychiat. 2020;11:595584. doi:10.3389/fpsyt.2020.595584Locke A, Kirst N, Shultz C.Diagnosis and management of generalized anxiety disorder and panic disorder in adults.Am Fam Physician. 2015;91(9):617-624.U.S. Food and Drug Administration.Selective serotonin reuptake inhibitors (SSRIs) information.Edinoff A, Akuly H, Hanna T, et al.Selective serotonin reuptake inhibitors and adverse effects: A narrative review.Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038Strawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.Expert Opin Pharmacother. 2018;19(10):1057–1070. doi:10.1080/14656566.2018.1491966Santarsieri D, Schwartz T.Antidepressant efficacy and side-effect burden: A quick guide for clinicians.Drugs Context. 2015;4:212290. doi:10.7573/dic.212290Schneider J, Patterson M, Jiminez X.Beyond depression: Other uses for tricyclic antidepressants. Cleveland Clinic.Anxiety & Depression Association of America.Benzodiazepines for general anxiety disorders (GAD).Quagliato L, Freire R, Nardi A.Risks and benefits of medications for panic disorder: A comparison of SSRIs and benzodiazepines.Expert Opin Drug Safety. 2018;17(3):315-324. doi:10.1080/14740338.2018.1429403Tiberewal P, Looi J, Allison S, Bastiampillai T.Benzodiazepines for the long-term treatment of anxiety disorders?.Lancet. 2021;398(10295):119-120. doi:10.1016/S0140-6736(21)00934-XU.S. Food and Drug Administration.Suicidality in children and adolescents being treated with antidepressant medications.Bernard MM, Luc M, Carrier JD, et al.Patterns of benzodiazepines use in primary care adults with anxiety disorders.Heliyon. 2018;4(7):e00688. doi:10.1016/j.heliyon.2018.e00688Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-94. doi:10.1111/bcp.12023Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152-155. doi:10.18773/austprescr.2015.055Silberman E, Balon R, Starcevic V, et al.Benzodiazepines: It’s time to return to the evidence.British J Psychiat. 2020;218(3):125-127. doi:10.1192/bjp.2020.164Boyd CJ, Austic E, Epstein-Ngo Q, Veliz PT, McCabe SE.A prospective study of adolescents’ nonmedical use of anxiolytic and sleep medication.Psychol Addict Behav.2015;29(1):184-191. doi:10.1037/adb0000026Henssler J, Heinz A, Brandt L, Bschor T.Antidepressant withdrawal and rebound phenomena.Dtsch Arztebl Int. 2019;116(20):355–361. doi:10.3238/arztebl.2019.0355Fluyau D, Revadigar N, Manobianco B.Challenges of the pharmacological management of benzodiazepine withdrawal, dependence, and discontinuation.Therap Adv Psychopharmacol. 2018;8(5):147-168. doi:10.1177/2045125317753340National Alliance on Mental Illness.Lorazepam (Ativan).

23 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialog Clin Neurosci. 2017;19(2):doi:10.31887/DCNS.2017.19.2/bbandelowAnxiety & Depression Association of America.Medication options.American Psychological Association.How hard is it to stop antidepressants?Garakani A, Murrough J, Freire R, et al.Pharmacotherapy of anxiety disorders: Current emerging treatment options.Front Psychiat. 2020;11:595584. doi:10.3389/fpsyt.2020.595584Locke A, Kirst N, Shultz C.Diagnosis and management of generalized anxiety disorder and panic disorder in adults.Am Fam Physician. 2015;91(9):617-624.U.S. Food and Drug Administration.Selective serotonin reuptake inhibitors (SSRIs) information.Edinoff A, Akuly H, Hanna T, et al.Selective serotonin reuptake inhibitors and adverse effects: A narrative review.Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038Strawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.Expert Opin Pharmacother. 2018;19(10):1057–1070. doi:10.1080/14656566.2018.1491966Santarsieri D, Schwartz T.Antidepressant efficacy and side-effect burden: A quick guide for clinicians.Drugs Context. 2015;4:212290. doi:10.7573/dic.212290Schneider J, Patterson M, Jiminez X.Beyond depression: Other uses for tricyclic antidepressants. Cleveland Clinic.Anxiety & Depression Association of America.Benzodiazepines for general anxiety disorders (GAD).Quagliato L, Freire R, Nardi A.Risks and benefits of medications for panic disorder: A comparison of SSRIs and benzodiazepines.Expert Opin Drug Safety. 2018;17(3):315-324. doi:10.1080/14740338.2018.1429403Tiberewal P, Looi J, Allison S, Bastiampillai T.Benzodiazepines for the long-term treatment of anxiety disorders?.Lancet. 2021;398(10295):119-120. doi:10.1016/S0140-6736(21)00934-XU.S. Food and Drug Administration.Suicidality in children and adolescents being treated with antidepressant medications.Bernard MM, Luc M, Carrier JD, et al.Patterns of benzodiazepines use in primary care adults with anxiety disorders.Heliyon. 2018;4(7):e00688. doi:10.1016/j.heliyon.2018.e00688Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-94. doi:10.1111/bcp.12023Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152-155. doi:10.18773/austprescr.2015.055Silberman E, Balon R, Starcevic V, et al.Benzodiazepines: It’s time to return to the evidence.British J Psychiat. 2020;218(3):125-127. doi:10.1192/bjp.2020.164Boyd CJ, Austic E, Epstein-Ngo Q, Veliz PT, McCabe SE.A prospective study of adolescents’ nonmedical use of anxiolytic and sleep medication.Psychol Addict Behav.2015;29(1):184-191. doi:10.1037/adb0000026Henssler J, Heinz A, Brandt L, Bschor T.Antidepressant withdrawal and rebound phenomena.Dtsch Arztebl Int. 2019;116(20):355–361. doi:10.3238/arztebl.2019.0355Fluyau D, Revadigar N, Manobianco B.Challenges of the pharmacological management of benzodiazepine withdrawal, dependence, and discontinuation.Therap Adv Psychopharmacol. 2018;8(5):147-168. doi:10.1177/2045125317753340National Alliance on Mental Illness.Lorazepam (Ativan).

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialog Clin Neurosci. 2017;19(2):doi:10.31887/DCNS.2017.19.2/bbandelowAnxiety & Depression Association of America.Medication options.American Psychological Association.How hard is it to stop antidepressants?Garakani A, Murrough J, Freire R, et al.Pharmacotherapy of anxiety disorders: Current emerging treatment options.Front Psychiat. 2020;11:595584. doi:10.3389/fpsyt.2020.595584Locke A, Kirst N, Shultz C.Diagnosis and management of generalized anxiety disorder and panic disorder in adults.Am Fam Physician. 2015;91(9):617-624.U.S. Food and Drug Administration.Selective serotonin reuptake inhibitors (SSRIs) information.Edinoff A, Akuly H, Hanna T, et al.Selective serotonin reuptake inhibitors and adverse effects: A narrative review.Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038Strawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.Expert Opin Pharmacother. 2018;19(10):1057–1070. doi:10.1080/14656566.2018.1491966Santarsieri D, Schwartz T.Antidepressant efficacy and side-effect burden: A quick guide for clinicians.Drugs Context. 2015;4:212290. doi:10.7573/dic.212290Schneider J, Patterson M, Jiminez X.Beyond depression: Other uses for tricyclic antidepressants. Cleveland Clinic.Anxiety & Depression Association of America.Benzodiazepines for general anxiety disorders (GAD).Quagliato L, Freire R, Nardi A.Risks and benefits of medications for panic disorder: A comparison of SSRIs and benzodiazepines.Expert Opin Drug Safety. 2018;17(3):315-324. doi:10.1080/14740338.2018.1429403Tiberewal P, Looi J, Allison S, Bastiampillai T.Benzodiazepines for the long-term treatment of anxiety disorders?.Lancet. 2021;398(10295):119-120. doi:10.1016/S0140-6736(21)00934-XU.S. Food and Drug Administration.Suicidality in children and adolescents being treated with antidepressant medications.Bernard MM, Luc M, Carrier JD, et al.Patterns of benzodiazepines use in primary care adults with anxiety disorders.Heliyon. 2018;4(7):e00688. doi:10.1016/j.heliyon.2018.e00688Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-94. doi:10.1111/bcp.12023Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152-155. doi:10.18773/austprescr.2015.055Silberman E, Balon R, Starcevic V, et al.Benzodiazepines: It’s time to return to the evidence.British J Psychiat. 2020;218(3):125-127. doi:10.1192/bjp.2020.164Boyd CJ, Austic E, Epstein-Ngo Q, Veliz PT, McCabe SE.A prospective study of adolescents’ nonmedical use of anxiolytic and sleep medication.Psychol Addict Behav.2015;29(1):184-191. doi:10.1037/adb0000026Henssler J, Heinz A, Brandt L, Bschor T.Antidepressant withdrawal and rebound phenomena.Dtsch Arztebl Int. 2019;116(20):355–361. doi:10.3238/arztebl.2019.0355Fluyau D, Revadigar N, Manobianco B.Challenges of the pharmacological management of benzodiazepine withdrawal, dependence, and discontinuation.Therap Adv Psychopharmacol. 2018;8(5):147-168. doi:10.1177/2045125317753340National Alliance on Mental Illness.Lorazepam (Ativan).

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Bandelow B, Michaelis S, Wedekind D.Treatment of anxiety disorders.Dialog Clin Neurosci. 2017;19(2):doi:10.31887/DCNS.2017.19.2/bbandelow

Anxiety & Depression Association of America.Medication options.

American Psychological Association.How hard is it to stop antidepressants?

Garakani A, Murrough J, Freire R, et al.Pharmacotherapy of anxiety disorders: Current emerging treatment options.Front Psychiat. 2020;11:595584. doi:10.3389/fpsyt.2020.595584

Locke A, Kirst N, Shultz C.Diagnosis and management of generalized anxiety disorder and panic disorder in adults.Am Fam Physician. 2015;91(9):617-624.

U.S. Food and Drug Administration.Selective serotonin reuptake inhibitors (SSRIs) information.

Edinoff A, Akuly H, Hanna T, et al.Selective serotonin reuptake inhibitors and adverse effects: A narrative review.Neurol Int. 2021;13(3):387-401. doi:10.3390/neurolint13030038

Strawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A.Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review.Expert Opin Pharmacother. 2018;19(10):1057–1070. doi:10.1080/14656566.2018.1491966

Santarsieri D, Schwartz T.Antidepressant efficacy and side-effect burden: A quick guide for clinicians.Drugs Context. 2015;4:212290. doi:10.7573/dic.212290

Schneider J, Patterson M, Jiminez X.Beyond depression: Other uses for tricyclic antidepressants. Cleveland Clinic.

Anxiety & Depression Association of America.Benzodiazepines for general anxiety disorders (GAD).

Quagliato L, Freire R, Nardi A.Risks and benefits of medications for panic disorder: A comparison of SSRIs and benzodiazepines.Expert Opin Drug Safety. 2018;17(3):315-324. doi:10.1080/14740338.2018.1429403

Tiberewal P, Looi J, Allison S, Bastiampillai T.Benzodiazepines for the long-term treatment of anxiety disorders?.Lancet. 2021;398(10295):119-120. doi:10.1016/S0140-6736(21)00934-X

U.S. Food and Drug Administration.Suicidality in children and adolescents being treated with antidepressant medications.

Bernard MM, Luc M, Carrier JD, et al.Patterns of benzodiazepines use in primary care adults with anxiety disorders.Heliyon. 2018;4(7):e00688. doi:10.1016/j.heliyon.2018.e00688

Hood SD, Norman A, Hince DA, Melichar JK, Hulse GK.Benzodiazepine dependence and its treatment with low dose flumazenil.Br J Clin Pharmacol. 2014;77(2):285-94. doi:10.1111/bcp.12023

Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr. 2015;38(5):152-155. doi:10.18773/austprescr.2015.055

Silberman E, Balon R, Starcevic V, et al.Benzodiazepines: It’s time to return to the evidence.British J Psychiat. 2020;218(3):125-127. doi:10.1192/bjp.2020.164

Boyd CJ, Austic E, Epstein-Ngo Q, Veliz PT, McCabe SE.A prospective study of adolescents’ nonmedical use of anxiolytic and sleep medication.Psychol Addict Behav.2015;29(1):184-191. doi:10.1037/adb0000026

Henssler J, Heinz A, Brandt L, Bschor T.Antidepressant withdrawal and rebound phenomena.Dtsch Arztebl Int. 2019;116(20):355–361. doi:10.3238/arztebl.2019.0355

Fluyau D, Revadigar N, Manobianco B.Challenges of the pharmacological management of benzodiazepine withdrawal, dependence, and discontinuation.Therap Adv Psychopharmacol. 2018;8(5):147-168. doi:10.1177/2045125317753340

National Alliance on Mental Illness.Lorazepam (Ativan).

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