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The Guide to Medications for Anxiety: Everything You Should Know

Article Summary:

An in-depth guide to anxiety medications, covering everything you need to know; different medications for anxiety, how they work, risks vs. benefits, and more...

Anxiety medications and antidepressants have consistently been among the most prescribed medications in the United States since their introduction - from the early Barbiturates to the Benzodiazepines and SSRIs used today.

The modern age of pharmaceutical anxiety treatment arguably began with the rise of Valium in the 1960s and 1970s and its successor, Xanax, in the 1980s and beyond.

Both remain among the most prescribed medications in the world today.

In the late 1980s and throughout the 1990s, the "breakthrough" SSRI drug fluoxetine – otherwise known as Prozac – was a top medication of choice for anxiety and depression and remains so.

After Prozac, other SSRIs became available, like Paxil and Zoloft (currently the most prescribed "psychiatric medication" in the United States).

Many people who have taken these medications for anxiety have reported some degree of relief from anxiety and panic attacks.

Others claim these drugs were life-changing or even life-saving.

But these medications are not without their potential for adverse effects.

For those who have experienced the darker side of these medications – side effects, physical dependence, withdrawals, and rebound anxiety- these drugs can be a real struggle.

While many of the adverse effects of these medications were known early on - over the past two decades, there has been a significant increase in awareness and research into their potential for addiction, discontinuation issues, and side effects.

If you hope to find the answers to your life's problems through a pill with no price to pay, you will likely be disappointed.

However, these medications may provide short-term relief and allow you to manage your anxiety better.

It is important to keep in mind these drugs aren't for everyone or needed by everyone.

You should weigh the potential risks and disadvantages in proportion to the supposed benefits.

There are also many safer alternatives to prescription medications available.

This website is dedicated to providing those very alternatives.

But for some, an anxiety medication may be integral to overcoming anxiety, panic, and fear.

This is especially true if you are dealing with deep-seated trauma, depression, severe panic, intense reoccurring fear, or OCD.

You may be able to better manage many of these associated issues with the assistance of medication.

In this article, we will provide a comprehensive overview of medications for anxiety.

We will neither demonize nor blindly praise these drugs – but will instead provide information – and let you decide if these medications could be an option for you.

We will also be answering many of the most common questions about anxiety medications:

  • Are these medications actually effective for anxiety?
  • How do they work?
  • What are the different types of anxiety medications?
  • What questions should I ask my doctor before taking these meds?
  • What are the potential risks involved with specific medications?
  • Do the benefits outweigh the potential risks?
  • Are there safer, effective alternatives to these drugs?
  • How do I know if I need medication for anxiety?

If you have any other questions this article doesn't answer, please reach out to us, and we'll do our best to answer them.

So let's dive in!


The information provided in this article should not be used as medical advice. We have attempted to provide a comprehensive and honest overview of medications for anxiety, but this is not meant to be taken as advice for medical treatment. Always discuss treatment options with a licensed healthcare professional. Only start or stop a medication with the guidance and support of your doctor. If something in this article raises a question or concern about a medication, discuss it with your doctor. This article is for informational purposes only.

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How Anxiety Medications Work: The Truth

When a person's anxiety and panic attacks get to the point where they think they may need medication, the typical first approach is to talk with their primary care physician.

In most cases, the doctor will recommend an antidepressant and explain how they may have a chemical imbalance in the brain or how these medications help to increase serotonin.

While antidepressants can help some people feel calmer and reduce anxiety symptoms, the explanation of how antidepressants work isn't exactly the truth – for one primary reasonno one knows with 100% certainty exactly how antidepressants work to reduce anxiety, depression, and panic attacks.

The whole "chemical imbalance" theory is just that – a theory. It's a hypothesis based on studies and experiments but has never been confirmed.

In fact, there is little evidence that these medications address any distinct underlying biological disorder at all!

There is also a different theory on how antidepressants work, changing the overall understanding of how these drugs benefit those who take them.

This theory states that antidepressant medications increase flexibility in the brain (through "remodeling" the neurons in the brain) so the brain can respond in new ways.

The alternative to antidepressants is typically a class of drugs known as Benzodiazepines.

If someone is seeing a psychiatrist or has tried antidepressants without benefit, Benzodiazepines are often the next step.

Benzodiazepines are much better understood than antidepressants for anxiety but carry significantly more risk for tolerance and addiction.

Whereas antidepressants are often prescribed and taken for more extended periods (months or even years) – Benzodiazepines (like Xanax) are generally prescribed for much shorter periods of time.


The medical and scientific community does not entirely understand how any of these medications work for anxiety (or depression). This is why you often see "The exact mechanism of action is unknown" within medical/scientific research for almost every anxiety medication.

Although we do not truly understand how these medications work – that's not saying they are ineffective or you should avoid ever taking them. They can be highly effective for some people (taking into account possible side effects and other issues).

While understanding exactly how these drugs work is unnecessary to benefit from them, you should be aware that they may not work for the reasons you think they are.

Just because a medication seems to have worked doesn't mean it worked because it corrected a chemical imbalance.

That said, all the information provided represents how these medications are believed to work to the best of our understanding.

Classes of Medications for Anxiety

We will discuss several classes of anxiety medications in this article.

Antidepressants: which include SSRIs, SNRIs, Tricyclics, and MAOIs

Benzodiazepines: drugs such as Xanax and Valium

Buspirone: similar to SSRIs but in a class of its own

Beta Blockers: drugs that reduce physical anxiety symptoms

Sedatives, Hypnotics, and Z-Drugs: these are generally prescribed for insomnia related to anxiety, stress, or trauma

We have purposefully left out drugs with an "off-label" use for anxiety.

Medications with an off-label use for anxiety are medications approved to treat a different medical condition but have the potential for anxiety-reducing effects.

Beta Blockers would be considered off-label anxiety medications. Still, we included them because they are commonly prescribed for physical anxiety symptoms.

We also left out medications that are rarely prescribed anymore, such as Barbiturates.


Antidepressants are typically a physician's first-line choice for patients with moderate to severe anxiety, panic attacks, OCD, and/or depression.

They are arguably the most effective medications for anxiety over the long term, with the least risk of addiction.

Antidepressants are the second most prescribed class of prescription medications in the United States – accounting for hundreds of millions of prescriptions filled every year.

According to the CDC, in the United States, during 2011-2014, 1 in 8 Americans (aged 12 and over) reported being on an antidepressant in the past month.

Over the years, that number has only increased.

It's not just in the U.S., however – in England, 70.9 million prescriptions were written for antidepressants in 2018.

Often, depression can accompany anxiety – making antidepressants a potentially beneficial treatment option for both anxiety and depression.

There is a lot of controversy around these medications, and they are often viewed in black or white terms.

But for the right person, at the right time, and used in the right way – they can effectively reduce anxiety, panic attacks, and obsessive-compulsive symptoms.

They can help those taking them to make the necessary changes they may not have been able to make otherwise.

Unlike Benzodiazepines – which can quickly reduce anxiety – antidepressants take time to work (typically between 2-4 weeks).

Many patients experience a temporary increase in anxiety before the anxiety declines and comes under control.

While the safety of long-term use of these medications is debatable, the consensus in the medical community is that they are generally safe for daily long-term use.

Many people take antidepressants for years without issue.

However, some stay on the medication because they find it too difficult to come off once taken for an extended period.

These people may also re-experience anxiety after coming off the medication if they haven't gone through therapy or learned effective techniques to cope with their anxiety.

Without the internal resources learned through strategies such as therapy or meditation – they may find the new anxiety symptoms difficult to handle.

The decision to come off these types of medications should be discussed with your doctor, and a tapering schedule (slowly lowering the dose) should be followed.

Discontinuation syndrome (a fancy way of saying withdrawals) can occur if these medications are stopped abruptly after long-term, daily usage.

Before starting these or any other medications, always discuss treatment options, questions, and concerns with your doctor.


SSRIs are the most commonly prescribed antidepressants and the likely first choice of most physicians for anxiety and depression.

SSRI stands for Selective Serotonin Reuptake Inhibitor.

SSRIs inhibit the reuptake (reabsorption) of serotonin – ultimately leading to increased serotonin available to bind to receptors in the brain.


SSRIs increase the availability of serotonin in the brain.

Although SSRIs can weakly influence other chemicals in the brain, such as norepinephrine – the first "S" for selective means it primarily has an affinity for serotonin.

The development of SSRIs was led by the demand for effective antidepressant medications that were more targeted (serotonin) – without the many side effects and potential toxicity of the older MAOIs and tricyclics.

The first successful SSRI to hit the market was Prozac.

It was so successful and effective that it seemingly confirmed to the medical community the involvement of serotonin in anxiety disorders and depression.

There are 6 SSRIs available today: fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), sertraline (Zoloft) and fluvoxamine (Luvox)

Side effects can be relatively common among antidepressants, and SSRIs are no exception.

Although considered a significant improvement over older antidepressants, close to 40% of those prescribed SSRIs reported experiencing one or more side effects.

Potential Benefits

  • Can reduce anxiety and panic attacks
  • Can help with social anxiety
  • Can be an effective approach to OCD
  • Non-addictive
  • Relatively safe for long-term use
  • Can help with depression
  • Improves the ability to make changes (in therapy and through self-care)
  • Believed to promote flexibility (neuroplasticity) in the brain

Potential Risks & Disadvantages

  • It may take some time to work: 1-4 weeks
  • It may initially increase anxiety for the first few days
  • Possibility of side effects
  • Discontinuation Syndrome can occur when stopping the meds after long-term usage
  • Stopping these meds needs to be done slowly and carefully under the supervision of a doctor
  • Relapse (reverting to being anxious) can occur after discontinuing
  • Increased risk of suicide among teens and young adults
  • A moderate percentage of patients experience sexual side effects

Possible Side Effects

In a study done in 2009 of 700 patients – 38% reported experiencing at least one side effect.

Below is a list of the side effects from most common to least common.

  • Sexual problems
  • Drowsiness
  • Weight Gain
  • Dry Mouth
  • Insomnia
  • Fatigue
  • Nausea


SNRIs are a newer class of medication used primarily to treat anxiety and depression but are also prescribed for chronic pain and fibromyalgia.

SNRI stands for Serotonin Norepinephrine Reuptake Inhibitor.


Like SSRIs, SNRIs increase the amount of serotonin available in the brain but also increase norepinephrine.

Norepinephrine's important role in depression is thought to be due to its ability to improve attention, memory, motivation, and focus (which can decline under depression) and its role in pain modulation.

The combination of increased serotonin and norepinephrine has shown to be more effective in some studies for chronic pain and fibromyalgia symptoms than increasing serotonin alone.

No clear advantage has been shown for SNRIs over SSRIs for anxiety or depression.

Some people respond better to SSRIs, while others may find an SNRI works better.

Common SNRIs medications include: Cymbalta, Effexor, Pristiq, and Fetzima

Potential Benefits

  • Can reduce anxiety and panic attacks
  • Can be effective for chronic pain and fibromyalgia
  • Can be an effective approach to OCD
  • Non-addictive
  • Relatively safe for long-term use
  • Can help with depression
  • Improves the ability to make changes (in therapy and through self-care)
  • Believed to promote flexibility (neuroplasticity) in the brain
  • It can help reduce headaches and migraines

Potential Risks & Disadvantages

  • It may take some time to work: 1-4 weeks
  • It may initially increase anxiety for the first few days
  • Possibility of side effects
  • Discontinuation Syndrome can occur when stopping the meds after long-term usage
  • Stopping these meds needs to be done slowly and carefully under the supervision of a doctor
  • Relapse (reverting to being anxious) can occur after discontinuing
  • Increased risk of suicide among teens and young adults
  • It may increase blood pressure in some people

Possible Side Effects

Side effects with SNRIs are similar to SSRIs – nausea and headache are more likely to occur with an SNRI than with an SSRI. Weight gain and sexual problems are more common with SSRIs than with SNRIs.


Tricyclic antidepressants – often abbreviated TCAs – were among the first antidepressants to be released (released alongside the first MAOIs).

TCAs are approved by the FDA for treating depression, OCD, and bedwetting but are also used for different types of anxiety.

TCAs were the dominant antidepressant until SSRIs came along in the 1980s.


TCAs work in a similar, but less targeted, way as SNRIs in that they increase both serotonin and norepinephrine – but they also affect other neurotransmitters such as acetylcholine.

Acetylcholine is the neurotransmitter responsible for many brain and nervous system functions, including memory and learning, alertness, attention, promoting REM sleep, and activating skeletal muscles.

Low acetylcholine has been linked to Alzheimer's – making Tricyclics (which lowers acetylcholine) a poor choice for those struggling with memory problems and older people.

Tricyclics' effect on the brain's neurotransmitters can vary depending on the actual type of TCA taken.

Some prescription TCAs have a stronger affinity for serotonin, while others affect norepinephrine more.

Some block more acetylcholine than others and can affect dopamine to a certain degree.

While TCAs are less likely to be prescribed for anxiety or depression compared to SSRIs or SNRIs – they have many "off label" (non-FDA approved) uses for which they can still be effective, including chronic pain, panic disorder (panic attacks), generalized anxiety (GAD), migraines, chronic headaches, premenstrual symptoms, and smoking cessation.

Like SSRIs and SNRIs – TCAs generally take time to work for anxiety and depression but can have more immediate effects on chronic pain.

TCAs generally have more side effects and aren't as well tolerated as SSRIs – especially at higher doses.

This higher potential for side effects and discontinuation is why SSRIs eventually replaced them and why Tricyclics are not prescribed as often today.

They can – however – be just as effective for anxiety and depression as the newer antidepressants for those who can tolerate them.

The side effects are less common and less severe when prescribed at lower doses, such as those used for pain or chronic headaches.

Common Tricyclic medications include amitriptyline (Elavil), clomipramine (Anafranil), nortriptyline (Pamelor), amoxapine, and desipramine (Norpramin).

Potential Benefits

  • Can reduce anxiety and panic attacks
  • Can help with chronic pain and headaches
  • Can be an effective approach to OCD
  • Non-addictive
  • Relatively safe for long-term use
  • Can help with depression
  • Improves the ability to make changes (in therapy and through self-care)
  • Believed to promote flexibility (neuroplasticity) in the brain
  • TCAs with a lower affinity for serotonin (such as Nortriptyline) are much less likely to cause sexual side effects than SSRIs

Potential Risks & Disadvantages

  • It may take some time to work: 1-4 weeks
  • It may initially increase anxiety for the first few days
  • Higher possibility of side effects compared to SSRIs or SNRIs
  • Stopping these meds needs to be done slowly and carefully under the supervision of a doctor
  • Relapse (reverting to being anxious) can occur after discontinuing
  • Increased risk of suicide among teens and young adults
  • Blocking Acetylcholine can cause memory/learning problems when using long term

Possible Side Effects

Tricyclics are generally not as well tolerated as SSRIs/SNRIs and have a higher percentage of side effects among patients. There is also an increased risk of toxicity and overdose with TCAs. Tricyclics have many of the same side effects as SSRI/SNRI, with a higher degree of reported dry mouth, dizziness, and constipation.


MAOIs were the first antidepressants on the market – created in the 1950s – and are still FDA-approved for depression.

MAOI stands for monoamine oxidase inhibitor.


Monoamine oxidase is an enzyme that breaks down serotonin, norepinephrine, and dopamine. By inhibiting this enzyme, the availability of those neurotransmitters increases.

Doctors do not prescribe MAOIs as often for anxiety or depression as they used to – except in particular cases or as an alternative when other medications have failed to work, such as in severe depression.

The reason for their falling out is the vast number of possible food and drug interactions.

If you've ever read the back of a medicine bottle of any kind, you've most likely seen the warnings regarding interaction with MAOI medications.

MAOIs can have numerous side effects, and the use of MAOIs needs to be monitored closely by a doctor.

That being said, MAOIs can be very effective for anxiety and depression under the proper circumstances or where nothing else has worked before.

Some people find that a particular MAOI is the only thing that works for them.

Common MAOI medications include Parnate, Marplan, Nardil, and Emsam.

Potential Benefits

  • It can reduce anxiety and panic attacks
  • It can help with moderate to severe depression
  • Can be an effective approach to OCD
  • Not addictive
  • Relatively safe for long-term use
  • It can work where other medications haven't

Potential Risks & Disadvantages

  • It may take some time to work: 1-4 weeks
  • It may initially increase anxiety for the first few days
  • Higher possibility of side effects compared to SSRIs or SNRIs
  • Stopping these meds needs to be done slowly and carefully under the supervision of a doctor
  • Relapse (reverting to being anxious) can occur after discontinuing
  • Increased risk of suicide among teens and young adults
  • High risk of interactions with many foods and medications
  • Increases the risk of low blood pressure

Possible Side Effects

MAOIs have many of the same side effects as the other antidepressants listed above but also have a higher risk of causing low blood pressure. In addition, food and other medications need to be closely monitored to avoid possibly severe drug interactions.


Benzodiazepines – often referred to as "Benzos" – are often the first medications that come to mind when discussing anti-anxiety medications.

They are often the first medications prescribed to someone diagnosed with a clinical anxiety disorder.


Benzodiazepines are considered minor tranquilizers that bind to the GABA receptor sites in the brain – increasing GABA's effectiveness in calming the mind and promoting mental and physical relaxation.

GABA is an inhibitory neurotransmitter responsible for reducing the excitability of neurons in the brain and nervous system.

Increasing GABA acts as a nervous system depressant – which all Benzodiazepines are.

By inhibiting neurons, the brain and body are much more relaxed, reducing anxiety, physical tension, and agitation.

Benzodiazepines have proven effective for various anxiety issues, including Generalized Anxiety Disorder (GAD) and Panic Disorder (panic attacks).

Benzodiazepines are generally recommended and prescribed for short-term use (2-4 weeks).

Drugs in this class have not shown effectiveness for long-term use due to patients increased tolerance to these drugs over short periods of time.

Unlike antidepressants which are much more targeted to the brain chemicals they affect (serotonin, norepinephrine, etc.) – benzodiazepines have a widespread effect throughout the brain and body.

This is not a good thing.

By inhibiting or sedating neurons throughout the body, you are affecting more than just the anxiety you are trying to treat.

By inhibiting your brain and nervous system, you also inhibit your ability to learn new things or form new memories.

These drugs strongly impact cognitive ability and cognitive decline can become significant after long-term use.

The most significant risks to taking Benzodiazepines are tolerance and dependence. This is why many physicians will not prescribe Benzos for long-term use.

Tolerance can build up within weeks or even days with these drugs.

The result of tolerance is the need for higher and higher doses to achieve the same benefits.

Physiological dependence can follow almost as quickly, with withdrawal effects seen even after short-term daily usage.

Due to their enormous potential for abuse and dependence – these drugs are typically only used and prescribed for short-term (immediate) relief of anxiety or medical issues such as alcohol withdrawal, prolonged seizures, or even before surgery or dental work.

When long-term support is needed for anxiety – antidepressants are the safer and more effective option.

We recommend avoiding these medications if possible.

If you take them – try taking them for as short a period as necessary.

No matter how well these medications work at the outset or how pleasant the feelings are – they will not last long, and the dose must be increased to get the same benefits.

Addiction and dependence are real and can be brutal with Benzodiazepines.

I've heard first-hand horror stories of withdrawals from these medications.

Unfortunately, the addiction issue with Benzo drugs such as Xanax and Klonopin (whether taken legally or illegally) doesn't get the same attention as opioids, even though the withdrawals can be as severe and longer-lasting.

When combined with other drugs, the risk of overdose is just as dangerous.

The most commonly prescribed benzodiazepines are Xanax, Klonopin, Valium, Ativan, and Restoril.

Potential Benefits

  • Very effective for anxiety and calming the mind and body
  • Rapid relief of anxiety symptoms
  • Can be taken on an as-needed basis
  • Can calm a patient before a medical or dental procedure

Potential Risks & Disadvantages

  • Physiological dependence and addiction can occur - even if taken short term
  • Not practical for long-term use
  • It can be fatal when combined with alcohol or other drugs
  • Side effects are common
  • Cognitive impairment can occur (problems with learning, memory, etc.) - which increases with long-term use
  • Severe withdrawal symptoms in some people
  • Rebound anxiety possible - anxiety worse than before starting the medication
  • Increased suicide risk among depressed patients

Possible Side Effects

  • Sedation
  • Dizziness
  • Depression
  • Memory problems
  • Cognitive decline
  • Coordination problems
  • Muscle weakness


Buspirone is a medication for anxiety that has been found particularly effective for generalized anxiety.

It has not been shown to be effective for more severe anxiety, OCD, or panic.


Buspirone is a medication in a class of its own. It is more closely related to SSRIs/SNRIs than to Benzodiazepines. Like SSRIs, it targets serotonin receptors in the brain but also affects dopamine receptors.

Like most prescription medications, "the exact mechanism of action" is not clearly understood.

It is believed to work by changing neurons in a way similar to SSRIs/SNRIs, but Buspirone affects dopamine levels as well.

While Buspirone is relatively safe to take long term – its effectiveness in reducing anxiety beyond 3-4 weeks has not been proven.

Potential Benefits

  • Effective for mild to moderate generalized anxiety disorder (GAD)
  • It can be used for short-term anxiety symptom relief
  • Non-addictive
  • Hasn't shown symptoms of withdrawal like benzodiazepines
  • It doesn't cause sedation in most people
  • Safe for long-term use (although long-term effectiveness has not been proven)

Potential Risks & Disadvantages

  • Possible side effects
  • It may not work for more severe anxiety, OCD, or panic attacks
  • Hasn't demonstrated effectiveness for long-term use (beyond four weeks)
  • It can be dangerous when mixed with alcohol
  • Certain foods (such as grapefruit) and other medications can inhibit the breakdown of this drug - leading to dangerous levels in the body
  • Increased suicide risk

Possible Side Effects

  • Dizziness (12%)
  • Drowsiness (10%)
  • Nausea (8%)
  • Headache (6%)
  • Nervousness (5%)


Beta-blockers – or "beta-adrenergic blocking agents" – are medications approved for patients with heart problems and high blood pressure but are commonly prescribed for physical anxiety symptoms.


Beta-blockers block the effects of the hormone/neurotransmitter epinephrine – otherwise known as adrenaline. By blocking epinephrine's effects – the usual physical effects of anxiety/panic (increased heart rate, sweating, trembling) are prevented or reduced.

Epinephrine is involved in the fight-or-flight response – thereby blocking epinephrine (adrenaline), you essentially block the fight-or-flight response.

Beta-blockers are not anxiolytics (anti-anxiety) – they only reduce the physical symptoms of anxiety.

Mental/emotional/psychological anxiety can still be present. Therefore, Beta Blockers are not an effective medication for anxiety other than managing physical symptoms.

Examples of their use could include; public performances where physical anxiety symptoms can interfere or for dealing with chronic intense physical symptoms of anxiety.

Physiological dependence can occur after daily use and increase blood pressure if discontinued abruptly.

Always talk with your doctor before stopping this medication.

Potential Benefits

  • Non-addictive
  • Reduces physical symptoms of anxiety
  • It can help deal with anxiety sensitivity
  • Can reduce panic attacks

Potential Risks & Disadvantages

  • Physiological dependence after daily use - discontinuation should be approached cautiously with your doctor
  • Possible side effects
  • Reduces the ability to tolerate anxiety symptoms
  • Reduces the effectiveness of exposure therapy

Possible Side Effects

  • Low blood pressure
  • Tiredness/fatigue
  • Dizziness
  • Cold hands/feet

Sedatives, Hypnotics, and Z-Drugs

Beta-blockers – or "beta-adrenergic blocking agents" – are medications approved for patients with heart problems and high blood pressure but are commonly prescribed for physical anxiety symptoms.


This class of drugs includes "benzo-like" medications that help with sleep and treat insomnia and work on GABA receptors similarly to other benzodiazepines, such as Xanax.

These drugs work by inhibiting neurons in the brain and nervous system, slowing and calming the mind and body to induce sleep.

Although not a prescription medication – Benadryl and many older antihistamines are also sedatives/hypnotics.

If you've taken Benadryl for allergies, you may have found this out firsthand if you began dozing off in the middle of the day.

Certain older antihistamines – like Benadryl – cross the blood/brain barrier and block histamine receptors that promote wakefulness, resulting in drowsiness.

Z-Drugs are a class of insomnia medication appropriately named for the "Z" in the name.

"Zolpidem" – otherwise known as Ambian – is one example of a Z-Drug.

These drugs are very much like Benzodiazepines but have different chemical structures. Both act on GABA receptors in the brain – however, Z-Drugs tend to cause more significant drowsiness versus anxiety-reducing effects.

Z-Drugs and the other benzo sedatives/hypnotics all possess the same potential risks and dangers of dependency and physiological dependence that other Benzodiazepines have.

I do not believe these drugs are safer than other Benzo drugs just because they are classified as insomnia medications.

Like Benzodiazepines – these medications should be used intermittently or for short periods only.

Dependence can build up rather quickly if taken every night.

They will begin to lose effectiveness, and more must be taken to achieve the same effect.

Another downside to these meds is that many people become reliant on them to fall asleep.

With continued use, the person taking them will likely reach the point where they can not fall asleep without them.

Addiction to Z-Drugs and other sedatives/hypnotics can occur within three weeks of use.

Z-Drugs can cause withdrawal effects similar to benzodiazepines.

These drugs can also cause strange and dangerous side effects, such as fully functioning sleepwalking and acting out bizarre or nonsensical behavior.

Many side effects can be avoided by using the correct dosage and taking the drug directly before sleep.

Most adverse effects occur when people take these drugs and stay up.

For example – taking the medication and then staying up to do household chores.

We recommend avoiding these drugs unless you have no other option – even then, only take them as needed and for as short a duration as possible. The risks far outweigh the benefits.

Potential Benefits

  • Can improve sleep
  • Can make it easier to fall asleep when overly stressed or anxious
  • Promotes relaxation
  • Can reduce anxiety and anxious thinking

Potential Risks & Disadvantages

  • Addictive
  • Possibly dangerous side effects
  • Can cause daytime sedation
  • Only effective for short-term use
  • Can cause depression
  • Moderate to severe withdrawals
  • Not recommended for older adults due to the risk of falls

Possible Side Effects

Although many of the side effects of these medications can be relatively minor – such as headaches or dizziness – there have been increasing reports over the past few years of some truly odd and dangerous effects of these drugs.

Sleepwalking: I've heard some crazy stories of patients waking up on park benches or several blocks from their homes.

Amnesia: not remembering anything that happened for the few hours after taking the medication.

Strange behavior: some truly odd behaviors can occur on these medications that someone normally wouldn't do otherwise.

  • Amnesia
  • Hallucinations
  • Sleepwalking
  • Strange/bizarre behavior
  • Headaches
  • Dizziness
  • Risk of falls

The Benefits of Anxiety Medication

All medications discussed in this article can have major advantages and disadvantages.

Even discussing the use of medication for anxiety can polarize those who have taken them or know someone who has.

While one person may claim a specific SSRI changed their life and helped tremendously with their anxiety and depression – another person may have taken the same drug and experienced significant side effects and withdrawals.

These medications are not without controversy.

With an increased risk of suicide with antidepressants and the potential for addiction with benzos and insomnia medications – these drugs shouldn't be considered harmless just because a doctor prescribed them.

They are powerful psychoactive medications that significantly affect the brain and nervous system.

That being said, they can be an effective option for anxiety, panic attacks, OCD, and social anxiety – as well as depression which can often accompany anxiety.

Despite the potential side effects and negative publicity – these medications can work for some people.

They may improve a person's life to a point they could not reach alone.

Whether it's finally coming out of the hole of a long depression – or finally calming anxiety after months or even years of daily struggle.

Before medication, a person may not have been able to leave the house without severe anxiety – now, they are back doing what they want/need to do.


To be clear – none of the drugs on this list are magic potions. Many of the medications listed can reduce anxiety symptoms or help you relax or sleep, but the actual benefits come from medicines that allow you to adapt, change and work through your anxiety.

These benefits can include: improving your response to therapy or allowing you to better cope with and accept the feelings of anxiety in social situations.

Antidepressants are the only anxiety medications available right now that can support change and growth and improve therapeutic approaches.

Anxiety is often a complex issue requiring more than just a temporary fix.

You may often need more than just a pill to reduce anxiety over the long term.

You need the skills to manage your anxiety – especially when you decide to stop taking the medication.

Taking a pill for a prescribed amount of time and then stopping, usually doesn't "fix" anxiety if the necessary changes haven't occurred or the internal resources to handle stress and anxiety better haven't been nurtured.

The ideal way to use these medications would be in conjunction with therapy or while practicing techniques (such as the ones provided on this website) so you can develop the internal resources and skills to deal with whatever arises.

You can then choose to come off the medication without relying on it to manage your anxiety.

Unfortunately, medications like benzodiazepines only numb us to our anxiety.

Benzodiazepines actually prevent new learning from occurring.

They can also make anxiety worse once stopped.

They are more of a hindrance to overcoming anxiety than a help.

All of the medications we've discussed in this article can provide the benefit of reducing anxiety.

Only antidepressants have the potential to support change and growth – especially in the long term.

The Dark Side of Anxiety Drugs

We briefly touched on the polarizing opinions of these medications above.

Many people have been prescribed these medications (or know someone who has) and have only experienced the dark side of these drugs.

I wanted to go into more depth here to make clear the potential risks and downsides of any medications we have discussed in this article.

There are valid reasons for caution, dislike, or even hatred of these medications.

While the adverse effects can vary from one type of medication to another – many common factors should be discussed as a possibility with all of these drugs.

This is something not all doctors are quick to talk about when prescribing.

It should be noted that everyone is different and will respond to a specific medication differently.

While one antidepressant may cause significant side effects in one person – another person may respond well to the same medication with little to no side effects.

The wide variation in people's experience with these drugs is one reason doctors will have a patient try different medications until they find the one that works best for that individual.


There are common potential risks among different types of medications, but there are no definite rules that apply to every person that takes them.

Antidepressants can cause sexual side effects and fatigue in a large percentage of those taking them.

For others, they may not or may even have the opposite effect.

Tolerance and physical dependency can build up quickly with benzodiazepines leading to moderate to severe withdrawals – but there is also a percentage of people who can take these drugs as needed for an extended period and stop without issue.

The items discussed below are possible problems that can arise from these medications. They are no definite rules that say – "You will experience these problems if you take medication for anxiety."

It is information so you are aware and can discuss it further with your doctor.

Side Effects

For most people, the number one concern with anxiety medications is usually side effects.

We want to know the potential side effects and how likely we are to experience them.

Most of the side effects of medications for anxiety have been well documented, and most people are aware that these drugs can have side effects to some degree or another.

The degree of intensity is what matters most.

Most people would probably be willing to put up with some minor fatigue if a medication took their daily anxiety from an 8 to a 4.

But if the fatigue were so bad they started falling asleep at work every day, they would probably want to switch medications.

The type of side effect can impact people differently.

Some people experience a minor to moderate increase in anxiety when first starting an antidepressant that diminishes over time.

This temporary increase in anxiety may lead them to believe the medication isn't working for them, or they may want to quit it early.

Other side effects like erectile dysfunction and other sexual side effects may be a deal-breaker for many.

The cognitive side effects of drugs like benzodiazepines or the fatigue experienced when starting an SSRI or SNRI may be problematic for those whose jobs require clear and focused attention.


Often side effects may disappear or reduce in intensity after taking a medication for a more extended period. The side effects tend to lessen as the brain and nervous systems become accustomed to the medication - usually after the first few weeks.

That doesn't mean you need to suffer through side effects or not discuss them with your doctor. Always speak up. If the side effects are bothering you, let your doctor know.

Long-term side effects need to be taken into account as well.

While benzodiazepines like Xanax may work very well for someone at first, they can also lead to memory and cognitive problems in the long run.

Someone taking Xanax may experience more severe anxiety after stopping the medication than what they experienced before taking the meds.

Always discuss the side effects you experience with your doctor – even if it is not considered an "official" side effect in the medical books.

I've heard many physicians claim a particular medication "couldn't cause that side effect," only to find that the side effect is gone after discontinuing the medication.

Always speak up!


Tolerance occurs with many prescription medications when they are taken repeatedly for an extended period.

Tolerance occurs due to the body's adaptation to the drug.

The body can adapt to medications due to faster drug metabolizing and reduced affinity between brain receptors and that particular medication.

Tolerance is a serious problem with benzodiazepine drugs like Xanax and Klonopin – which can build up in a few short weeks to the point where the prescribed dosage no longer has the same (or any) effect.

Increased tolerance eventually leads to higher and higher dosages to achieve the same results.


Increased tolerance eventually leads to higher and higher dosages to achieve the same results. These higher dosages lead to a higher risk of side effects and increased physiological and psychological addiction risk.

The issue of rapid tolerance is why benzodiazepines should be avoided if possible or only taken for a short time.

While not as often discussed – tolerance can also occur with antidepressants and other medications.

Although typically occurring much slower than with benzos – after months of daily use, some may find they need to increase their dosage of antidepressants to deal with anxiety or their depression seems to be "breaking through."

Tolerance is an issue that you should discuss with your doctor.

It can be wise to ask how long they believe you should take the medication and whether higher doses will be needed.

Addiction, Dependency & Discontinuation Syndrome

Of all the adverse effects of anxiety medications – the potential for physiological and psychological dependency and addiction are probably the worst.

Benzodiazepines have a well-known potential for physical dependency, abuse, and addiction.

While most in the medical field know of this potential, there has yet to be a real widespread effort to curb its use.

Many people are being prescribed these medications without being made aware of this issue.

Addiction to benzos is real and can be excruciatingly difficult to come off of.

I've often heard stories of withdrawals described as worse than heroin, with withdrawal symptoms lasting for weeks or even months.

Drugs like Xanax, Valium, and Klonopin are often sold on the street in the same way opioid medications like Percocet and Vicodin are illegally sold.

There is a real problem here that needs to be brought to public awareness in the same way the opioid epidemic has been.

Less often discussed – and not entirely accepted by the medical community – is the physiological dependence on antidepressants after extended daily use.


After years of denying that antidepressants can cause physiological dependence, the medical community has finally given a name to the severe effects that some people experience after stopping these medications: "discontinuation syndrome."

The name is really just a fancy term for withdrawals.

The withdrawals that some experience from stopping antidepressants is due to the brain and body's dependence on the medication after months or years of daily intake.

Your brain can rely on these medications to produce specific brain chemicals such as serotonin.

When the meds are stopped – it can take weeks or even months to return to a balanced state.

While not everyone who stops taking antidepressants experiences these side effects – they can be severe for some, causing the person to return to the medication.

I experienced severe withdrawals after stopping the antidepressants I was on afer almost a decade of daily use. It took many attempts and nearly two years to get off my medications successfully. Even then, I experienced the so-called "brain zaps," severe anxiety, restlessness, inability to concentrate, severe brain fog, and other side effects for months on end.

In all circumstances – discontinuing any of the medications discussed in this article should be done under the supervision of your doctor and almost always involves tapering the dose very slowly over an extended time frame.

While it may not eliminate all the withdrawal symptoms, it is the safest and easiest way to stop.

Never stop these meds cold turkey- especially if taken for a long time.

Therapy & Exposure Interference

Hopefully, your goal on this journey is to not only reduce anxiety symptoms but also improve your ability to handle anxiety and stress and overcome your fears and resistances.

Whether you achieve this through psychotherapy, CBT, meditation, relaxation, or any other techniques or practices (like the ones discussed throughout this website) makes no difference.

All anxiety medication should ultimately be viewed as either helping you on this path or interfering.

Taking a pill to feel less anxious sounds much easier for most people than learning breathing techniques or going through therapy.

Often a person may feel a lot better on medication than before, so they neglect the additional work of therapy or learning learn how to cope with anxiety when it does arise.

Some people may think a pill will solve their problems, and they can avoid ever feeling anxiety, facing their fears, or dealing with the underlying causes.

Unless a person is planning to stay on medication permanently (and even on medication), there will come a time when they will need the skills and resources necessary to handle their anxiety.

Learning strategies for anxiety or going through therapy can help in this regard.

Exposure is common in many therapies.

Exposure therapy is where someone does the thing that makes them anxious and feels the anxiety to its fullest – seeing that it is safe.


Many medications would block people from experiencing these feelings, so they do not learn to see these anxious feelings as uncomfortable but not dangerous.

Medications can numb you to your anxious feelings, so you do not discover how to cope with them.

That's not to say certain medications can't help you on your journey or improve your therapy sessions.

Certain medications (particularly antidepressants) can improve s person's ability to cope with stress, life changes, and processing unresolved emotions.

Benzodiazepines, on the other hand – interfere with therapy and anxiety strategies because benzos inhibit new learning from taking place.

Beta-blockers can also interfere with therapy by blocking the physical sensations of anxiety – eliminating the need to learn how to calm and relax our physical response to stress and anxiety.

Rebound Anxiety

Rebound anxiety refers to increased anxiety and panic experienced after stopping a medication prescribed for anxiety.

In many cases, rebound anxiety can be more severe than the anxiety experienced before starting the medication.

The resulting anxiety and panic symptoms directly result from withdrawal from the medication.

Most people will run back to taking the medication to reduce the feelings of intense anxiety.

Their physicians may oblige with a higher dose to combat the increased anxiety.

Attempts to stop the drug can create a vicious cycle of higher and higher doses and intense anxiety and panic when trying to reduce or eliminate the drug.

Drug Interactions

A common issue with almost all medications for anxiety is drug interactions, particularly with other medicines and alcohol, which can also include herbs, supplements, and certain foods.

You are probably well aware of the potential for drug interactions with most of these medications.

Still, you should always discuss with your doctor if in doubt.

Many potential interactions, even with potentially benign supplements, can lead to health issues.

For example: combining antidepressant medications with herbs or supplements that affect serotonin (such as 5-HTP or St. Johns Wort) can lead to serious issues such as "Serotonin Syndrome."

Also, potentially fatal interactions can occur with anxiety meds and other medications or drugs.

Combining nervous system depressants such as benzodiazepines or sedatives with other nervous system depressants such as alcohol or opioids can lead to overdose, coma, or even death.


With these medications, alcohol should be limited or even avoided, and you should discuss other medications, supplements, or herbs with your doctor

MAOIs are known for having the most interactions and possibly the strictest medications discussed.

All medications (even over the counter meds) and foods must be closely monitored for possible interactions with any MAOI medication.

When taking anxiety medications – being open and honest with your prescribing physician about the supplements, herbs, and other drugs (including alcohol and street drugs) you are taking can help to avoid likely interactions.


Taking medication for anxiety can be extremely helpful for many people – and even necessary for some.

There is no denying the fact medications have helped many people deal with their anxiety and depression where nothing else would.

That being said, there tends to be an over-prescribing of these meds by overly eager family physicians and psychiatrists.

These medications CAN help – but they are not always necessary or needed.

Therapy, changes in diet, exercise, meditations such as Yoga and Mindfulness training, and many other techniques have proven to be just as effective as medication for anxiety and depression without the potential for side effects or physiological dependence.

Often anxiety medications are prescribed without looking at the patient's current diet or lifestyle.

Rarely are blood tests ordered to rule out possible biological causes for the patient's anxiety.


Doctors are much faster to prescribe medication than they are to recommend a therapist or that the patient practice meditation

I've experienced this over-prescribing firsthand. My family physician prescribed Prozac for my anxiety when I was 15. I was never asked what was going on in my life, whether or not I had a healthy/safe/loving home environment, nor did he recommend seeing a therapist. No tests were done, and no questions about my diet or physical activity were asked.

A 10-minute doctor visit led to a decade of my life on antidepressants.

Medications for anxiety are not always necessary.

While some people may need medication to truly manage their crippling anxiety, whether for the short or long term, many people do not.

Many will do as well or better using the techniques discussed throughout this website.

Physicians – especially in the US – need to take a closer look at the patient as an individual before prescribing these powerful psychotropic drugs. With the many alternatives available today for anxiety, medication no longer needs to be the first option unless necessary.

How to Determine if Medication May Be Needed

You should make the decision to take medication for anxiety with the help of a knowledgeable physician.

You should also be aware of and discuss these medications' potential side effects and other possibilities with your doctor.

Ideally, you would discuss lifestyle and health factors with your doctor beforehand to eliminate other possible causes of your anxiety.

While there isn't a 100% accurate test to determine if medication is needed, you can look deeper into a few questions to determine if anxiety medication would be the right choice for you.

Questions To Determine if Medication Could Be Helpful

  • How severe is your anxiety on a daily basis? (On a scale of 1-10)
  • Does your anxiety consistently interfere with your life and keep you from doing the things you want/need to do?
  • Do you have moderate or severe depression along with your anxiety?
  • Do you experience panic attacks regularly?
  • Are you currently in therapy, or have you done therapy in the past, and are you still overly anxious?
  • Have you tried practices or techniques for anxiety, such as deep breathing, meditation, or yoga?
  • Have you seriously looked at your diet and physical activity?
  • How long have you had anxiety?
  • Have you had any medical tests done to rule out potential biological causes (such as thyroid or vitamin/nutritional deficiencies)?
  • Are you too anxious to even try therapy or meditation?
  • Does your anxiety keep you from leaving the house?
  • Have you tried herbs or supplements?

Questions like the above can give you a better perspective on your anxiety and whether medication may be needed.

If you answered yes to most or all of the questions above, your anxiety is consistently above a six on a daily basis, and you've had moderate to severe anxiety for more than a few weeks now – it may be time to talk to your doctor.

Ultimately, it is your decision whether to take medication.

The advice of your doctor, along with information, can help you to make a more informed decision.

You can use the information in this article to help you with questions or concerns about potential medications so you can communicate these concerns with your doctor.

Alternatives to Prescription Medications

Over the past few decades, studies have been conducted to determine the efficacy of various treatment options for anxiety.

Many of these studies have proven the effectiveness of many techniques and therapies.

Some of these strategies have proven to reduce anxiety as much as or more than prescription medications – without the side effects or dependency.

Techniques and therapies proven effective for anxiety include:

  • Cognitive Behavioral Therapy (CBT)
  • Meditation and Mindfulness Practices
  • Yoga
  • Deep Breathing and Breath Practices
  • Improving/Changing Diet
  • Certain Forms of Psychotherapy
  • Exercise
  • Progressive Relaxation
  • EFT/Tapping

Extensive research has also been done on herbs, herbal extracts, and supplements for anxiety.

Comparisons have been made in controlled studies between these herbs, supplements, and anxiety medications.

While much of the research continues, the current research has provided evidence that many herbs and supplements can be a slightly less effective but much safer alternative to prescription medications for anxiety.

Herbs and supplements proven to be nearly as effective as prescription medications for anxiety:

  • 5-HTP
  • Ashwagandha
  • Kava
  • Rhodiola Rosea
  • Passionflower
  • Valerian Root
  • Theanine

If you're looking for alternatives to anxiety medications – look no further than our website.

You can find our extensive list of recommended supplements here

We have dedicated our site to providing alternatives to medication – with techniques, therapies, and supplements that have been proven effective for anxiety.

Websites like also provide an extensive overview of hundreds of herbs and herbal supplements cited and supported by all available research.

While medication can be an effective treatment option and, in some cases, a necessary one, it is not the only option for those with anxiety.

Talking With Your Doctor About Anxiety Medications

If you're considering medication for anxiety or your doctor has recommended medication, taking the extra time to ask questions or discuss concerns with your doctor first can help you better understand what to expect.

Reading through this article may have brought up information you were unaware of and something you would like your doctor to clarify.

Many physicians may gloss over the potential side effects of these medications and other important information you need to know before starting.

If you have questions or concerns – ask!

Any doctor worth their title will be open and honest and take the time to explain the whats, hows, and whys of these medications.

No physician or psychiatrist should try to pressure you into taking a medication you do not want to take.

If you've had a negative experience with a particular medication, let them know.

If you've heard horror stories about a particular med – ask them about what you've heard.

Not everything you read on the internet is valid or as dramatic as it may seem – but medications cause problems for people that doctors and drug companies do not want to admit to.

When discussing medication options with your doctor – it's best to be as transparent and honest as possible. Doing so can help your doctor prescribe the medication best suited to your anxiety issues.

For example, don't feel embarrassed to tell them if you're incredibly anxious in social situations or have panic attacks every time you go to the store.

This information is essential to find the best medication.

Some meds work better for social anxiety and panic than others.

Tell your doctor if you constantly obsess over things, have intrusive obsessive thoughts, or uncontrollably repeat particular behaviors.

OCD can respond well to medication, but you must let them know what you are experiencing to find the best possible remedy.

Important questions you may want to ask your doctor before taking an anxiety medication:

  • "Why do you think this medication would be best for me?"
  • "What side effects do most people report?"
  • "How long do you think I'll need to take it?"
  • "Are there any drug interactions I should be aware of?"
  • "Do you think this medication will help with _____________?"
  • "Is this medication habit-forming or hard to come off of?"
  • "I currently take ______________ (any medications or supplements), could there be any potential interactions with this medication?"
  • "I heard this medication can __________________ , is that true?"
  • "Are there any negative effects of taking this long term?"
  • "Will this medication interfere with my ability to _____________ ?"
  • "How long does it usually take to start working?
  • "Will I be able to take the same dose, or will I have to increase it over time (tolerance)?"

Being clear, open, and honest with your doctor while bringing up any questions, fears, or concerns you may have is the best approach to discussing medications.

There are no stupid questions.

As the patient, you're not expected to know all of the details of medications.

The doctor is there to provide that information – to give his advice based on his knowledge and experience.

So be upfront with them and ask questions!

Final Thoughts

We've tried to provide a clear, comprehensive, and honest overview of the various anxiety medications available.

Hopefully, you now better understand the possible benefits and potential risks of these medications.

Too often, we only hear one side of the story.

Searching through forums or reviews online, you may encounter horror stories regarding these medications from (rightfully) upset patients.

Talking with a doctor or reading medical websites, you may only hear of the benefits of these meds – neglecting the genuine potential for side effects, dependency, and withdrawals.

Although how these medications help those with anxiety (and depression) is still not clear, they can provide significant benefits and relief from moderate to severe anxiety for some people.

If you are considering taking prescription medication for anxiety – discuss options and potential risks thoroughly.

Ask questions.

If you're hesitant to try a medication due to something you've heard, read, or from previous experience, bring that up to your doctor.

We've tried to be as thorough as possible in this article, but if you have any questions about medications for anxiety, please email us at and we will do our best to answer.

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