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Anti-Anxiety Medications

Understanding anxiety medications, from short-term relief to long-term management options for finding calm and control.

Remember:Many effective anti-anxiety medications are non-addictive when used properly under medical supervision.

Written by

Dr. Bessy Martirosyan

Reviewed by

Kevin Hamilton, PMHNP

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Understanding Anti-Anxiety Medications

Anti-anxiety medications help manage symptoms of anxiety disorders by affecting neurotransmitters in the brain. There are several types, each working differently and suitable for different situations - from occasional panic attacks to chronic anxiety management.

Conditions Treated:

✓ Generalized Anxiety Disorder (GAD)
✓ Panic Disorder
✓ Social Anxiety Disorder
✓ Specific Phobias
✓ Performance Anxiety
✓ Acute Stress Reactions
✓ Anxiety with Depression

Types of Anti-Anxiety Medications

SSRIs/SNRIs (First-Line Treatment)

Best for long-term anxiety management

Escitalopram (Lexapro)
Sertraline (Zoloft)
Paroxetine (Paxil)
Venlafaxine (Effexor XR)
Duloxetine (Cymbalta)

Advantages: Non-addictive, treats anxiety and depression, well-studied safety profile.

Benzodiazepines (Short-Term Relief)

Fast-acting for acute anxiety

Alprazolam (Xanax)
Lorazepam (Ativan)
Clonazepam (Klonopin)
Diazepam (Valium)

Important: Risk of dependence with long-term use. Best for short-term or as-needed use.

Buspirone (Unique Option)

Non-sedating, non-addictive

Works differently than other anti-anxiety meds
Takes 2-4 weeks to work
No risk of dependence
Minimal sedation

Best for: People who want to avoid benzodiazepines or have substance use history.

Beta Blockers

For physical symptoms of anxiety

Propranolol (Inderal)
Atenolol (Tenormin)
Controls heart rate, tremors
Great for performance anxiety

Note: Doesn't affect psychological symptoms, only physical ones.

Antihistamines

Mild anxiety relief

Hydroxyzine (Vistaril, Atarax)
Fast-acting (30-60 minutes)
Non-addictive
Can cause drowsiness

Use: Good for mild anxiety or as adjunct treatment.

Other Options

Alternative approaches

Pregabalin (Lyrica)
Gabapentin (Neurontin)
Some antipsychotics (low dose)
Certain antidepressants

When used: Treatment-resistant cases or specific conditions.

Comparing Anti-Anxiety Medications

Medication Type	Onset of Action	Duration	Addiction Risk	Best For
SSRIs/SNRIs	2-6 weeks	Long-term	None	Chronic anxiety
Benzodiazepines	15-30 minutes	4-12 hours	High	Acute panic/short-term
Buspirone	2-4 weeks	Long-term	None	GAD without panic
Beta Blockers	30-60 minutes	4-6 hours	None	Performance anxiety
Hydroxyzine	30-60 minutes	4-6 hours	None	Mild anxiety/sleep

Understanding Benzodiazepines

Benzodiazepines are powerful anti-anxiety medications that work quickly but require careful management due to dependence risks.

⚠️ Important Safety Information

Risk of physical and psychological dependence
Tolerance can develop (need higher doses for same effect)
Never stop suddenly - requires gradual tapering
Can impair memory and coordination
Dangerous when combined with alcohol or opioids

When Benzodiazepines Are Appropriate

✓ Severe panic attacks
✓ Short-term crisis situations
✓ Bridge therapy while waiting for SSRIs to work
✓ Specific phobias (flying, medical procedures)
✓ Acute stress reactions

Safe Use Guidelines

Limit Duration
Use for shortest time possible, typically 2-4 weeks maximum for daily use.
As-Needed Use
When possible, use only during acute anxiety episodes rather than daily.
Regular Monitoring
Frequent check-ins with provider to assess need and watch for dependence.
Tapering Plan
Always have exit strategy - gradual dose reduction over weeks to months.

Non-Addictive Alternatives

Many effective anxiety treatments carry no risk of dependence, making them safer for long-term use.

✓ First-Line Non-Addictive Options

SSRIs/SNRIs

Gold standard for anxiety treatment. No addiction potential, effective for most anxiety disorders.

Buspirone

Specifically for anxiety, no sedation or dependence. Takes time to work but very safe.

Therapy + Medication

CBT combined with medication often more effective than medication alone.

Side Effects by Medication Type

SSRIs/SNRIs Side Effects

Initial anxiety increase (temporary)
Nausea, headache
Sleep changes
Sexual side effects
Weight changes

Usually improve after 2-3 weeks

Benzodiazepine Side Effects

Drowsiness, sedation
Dizziness
Memory problems
Coordination issues
Dependence risk

Monitor closely with provider

Buspirone Side Effects

Dizziness
Headache
Nausea
Nervousness (initially)

Generally well-tolerated

Frequently Asked Questions

When to Contact Your Provider

⚠️ Seek Immediate Help If:

Suicidal thoughts or self-harm urges
Severe allergic reaction
Confusion or memory loss
Difficulty breathing
Signs of dependence (needing more for same effect)

Schedule an Appointment For:

Medication isn't helping after adequate trial
Side effects interfering with daily life
Need for dose adjustment
Questions about tapering or switching
Breakthrough anxiety despite medication

Find Your Path to Calm

Our experienced team will help you find the right anxiety treatment approach for your unique needs.

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Important Medical Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider about your specific situation. Never start, stop, or change your medication without professional medical guidance.