Anxiety Medications Fast Facts

Last updated:February 26, 2024

Anxiety is a normal reaction to stress, but for some people, it can become overwhelming and debilitating. People with types of anxiety disorder feel apprehensive and uneasy, and it’s common for them to experience negative thoughts that make them more fearful.

According to the National Institute of Mental Health (NIMH):

More than 40 million American adults ages 18 and older have an anxiety disorder, and nearly one-third of adults will experience an anxiety disorder at some point in their life.
Anxiety disorders frequently co-occur with depressive disorders or substance abuse.
Most people with an anxiety disorder also have depression.
Most people with an anxiety disorder develop symptoms by age 21.

To help diagnose an anxiety disorder, a doctor will test to see if a medical condition or treatment is at the root of anxiety symptoms. For example, hypothyroidism or lupus may cause symptoms of anxiety, and anxiety can be a side effect of medications that treat rheumatoid arthritis or psoriasis. If no underlying cause is found, a psychological evaluation can help determine if an anxiety disorder is present.

According to the Centers for Disease Control and Prevention, symptoms of anxiety disorder increased considerably during the 2020 COVID-19 pandemic. Talking to a mental health professional can help people learn to cope when symptoms become overwhelming, particularly during stressful times.

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Common types of anxiety disorders include:

Generalized anxiety disorder (GAD), which is characterized by persistent unrealistic worry about everyday things, most days for at least six months.
Panic disorder, in which people experience sudden attacks of intense terror, brought on unexpectedly or by a feared object or situation. Panic attacks can cause symptoms such as chest pain, heart palpitations, shortness of breath and dizziness, and can be mistaken for a heart attack. Sometimes people develop a fear of going places where they have had previous panic attacks or situations in which a panic attack has occurred.
Agoraphobia, where people with panic disorder stick to places they consider safe and avoid public places (such as malls, trains, and stadiums) where escape may be difficult. As a result of avoiding these places or situations, about one in three people with panic disorder develops agoraphobia. Some people develop a fixed route or territory, and it may become impossible for them to travel beyond their safety zones without suffering severe anxiety or a panic attack.
Social anxiety disorder, an intense fear of being judged by people in a social situation, such as meeting new people or public speaking.
Specific phobias, fear of specific objects or situations that are out of proportion to the danger that may be present, typically lasting for at least six months. Common phobias include fear of flying, fear of heights, or fear of enclosed spaces.
Post-traumatic stress disorder (PTSD), reliving a traumatic experience through flashbacks, nightmares, or intrusive memories after undergoing a period of extreme stress. In addition to re-experiencing the trauma, symptoms of PTSD include avoidance of any reminders of the trauma, negative feelings about oneself such as guilt or blame, and constantly feeling on edge. These and other symptoms must be present for at least one month and interfere with work or relationships for a PTSD diagnosis.

Anti-Anxiety Medications

The first choice of medication for an anxiety disorder is usually an antidepressant, either a selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI). If these don’t help, tricyclic antidepressants (TCAs) may be tried.

Common SSRIs include:

Celexa (citalopram)
Lexapro (escitalopram)
Luvox (fluvoxamine)
Paxil (paroxetine)
Prozac (fluoxetine)
Zoloft (sertraline)

Common SNRIs include:

Effexor XR (venlafaxine)
Cymbalta (duloxetine)

Common side effects of SSRIs and SNRIs include:

headache
nausea
sleeplessness
drowsiness
agitation (feeling jittery)
sexual problems
diarrhea
constipation
changes in taste
dry mouth

Call your doctor if you experience any of these serious side effects:

seizures
hallucinations
confusion
difficulty breathing
chest pain
unusual bleeding or bruising
irregular heartbeat
uncontrollable muscle twitching or jerking

Common TCAs include:

Anafranil (clomipramine)
Tofranil (imipramine)

Common side effects of TCAs include:

dry mouth
constipation
urinary retention
drowsiness
dizziness
weight gain
sexual dysfunction
orthostatic hypotension (reduced blood pressure upon standing)

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Call your doctor if you experience any of these serious side effects:

seizures
uncontrollable shaking of a body part
irregular heartbeat
loss of bladder control
difficulty urinating
hallucinating
difficulty breathing or fast breathing
severe muscle stiffness
muscle spasms of jaw, neck or back
difficult or slow speech
shuffling walk

Benzodiazepines

Benzodiazepines are considered a second-line treatment for anxiety disorders. They are usually prescribed for short-term or occasional use due to the risk of dependency. However, they can take effect more quickly than antidepressants. Still, in October 2023, researchers found that the efficacy of Xanax XR, a commonly used benzodiazepine, was inflated by more than 40% in clinical trials. “This study will reinforce being cautious about starting a prescription,” a study author said.

In September 2020 the Food and Drug Administration strengthened the boxed warning for benzodiazepines to emphasize the serious risks of abuse, addiction, dependence and withdrawal associated with taking them. However, they can take effect more quickly than antidepressants and are still helpful when used properly