Highlights
- Anxiety medications, also called anxiolytics, help manage generalized anxiety disorder (GAD).
- Anxiety medications are usually paired with talk therapy techniques and are prescribed by a psychiatrist.
- There are several classes of drugs and individual medications to treat anxiety.
- BidRX can help you get the best price on anxiety medications.
Anxiety is a normal emotion, and we all feel it sometimes. If anxiety is making it difficult to see friends, go to work, or otherwise live your life, then you may be experiencing an anxiety disorder. Anxiety medications, also known as anti-anxiety drugs, anti-panic drugs, and anxiolytics, are a useful tool for managing anxiety disorders. If you’re taking an anti-anxiety medication, BidRX can get you the best price.
Anxiety Medications — Overview
The two most common classes of anxiety medication are antidepressants and benzodiazepines. Each has its own mechanism of action, side effects, and contraindications. They’re often prescribed together to balance each other out.
In addition, pregabalin, an anticonvulsant, and buspirone, a serotonin antagonist, are often used to treat anxiety.
Antidepressants
Antidepressants have been found to help with anxiety disorders, usually limiting the length and severity of episodes. They’re also used for people who have other mental health concerns in addition to anxiety, such as depression and post-traumatic stress disorder.
The main classes of antidepressants are:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
- Atypical agents
Of these, SSRIs and SNRIs have been found to be most effective at treating anxiety. The other three may be used in rare situations such as allergy, but they aren’t recommended due to their stronger side effects and more limited effectiveness at treating anxiety. People taking anxiety medications should avoid MAOIs in particular, as they have a broad range of drug interactions.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) limit the reabsorption of serotonin, a key neurotransmitter involved in regulating mood. Many people taking SSRIs describe them as having a “dialing back” effect on anxious thoughts that allows them to engage with other forms of treatment, such as talk therapy. SSRIs generally take approximately two to four weeks to produce effects.
SSRIs are often prescribed along with a low-dose benzodiazepine to limit the physical symptoms of anxiety. Benzodiazepines may be used as a stopgap to help manage symptoms and give the SSRI a chance to take effect.
Examples of SSRIs include:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Fluvoxamine (Luvox)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
Fluoxetine and fluvoxamine are also available in controlled-release (CR) formulas.
Contraindications — SSRIs
Don’t take SSRIs if you have the following conditions:
- Bleeding disorders or currently healing injuries
- Diabetes
- Epilepsy
- Narrow angle glaucoma
- Kidney, liver, or heart disorders
Warnings — SSRIs
SSRIs may increase the risk of suicidal thoughts, especially in teenagers and young adults. If you’re experiencing suicidal thoughts or ideation, discontinue your medication and contact your doctor immediately.
Side Effects — SSRIs
Common side effects can include:
- Nausea and vomiting
- Diarrhea
- Headache
- Dizziness
- Weight gain
- Sexual side effects such as low libido or erectile dysfunction
- Sleep symptoms, including insomnia
Risk of abnormal bleeding and bone fracture may also be higher when you take SSRIs.
Drug Interactions — SSRIs
SSRIs shouldn’t be combined with any other medication that affects serotonin. These interactions can increase your risk of serotonin syndrome, which is potentially fatal.
Drugs to avoid include:
- Other SSRIs and antidepressants
- Triptans (migraine drugs)
- Meperidine (Demerol)
- Tramadol (Ultram)
SSRIs can also interact with herbal supplements, including St. John’s Wort and street drugs such as cocaine and MDMA (ecstasy). It’s strongly recommended that you discontinue all herbal supplements and avoid street drugs as part of limiting anxiety.
If you’re taking SSRIs, you should limit alcohol consumption. If you’re combining an SSRI with a benzodiazepine for anxiety, you will need to phase out alcohol completely. The interaction of the three can have effects that are difficult to predict or that may interfere with daily life.
Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil and Motrin) and naproxen sodium (Aleve), and blood thinners, such as warfarin (Coumadin), may also pose a risk because SSRIs increase the risk of abnormal bleeding. If you need to take a blood thinner, consult with your doctor about your options.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are similar to SSRIs with the exception that they act on two neurotransmitters instead of one. SNRIs are also used to treat chronic pain and fibromyalgia.
Similar to SSRIs, SNRIs generally take between two and four weeks to show a full effect.
Examples of SNRIs include:
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor)
- Milnacipran (Savella)
- Levomilnacipran (Fetzima)
Contraindications — SNRIs
If you have uncontrolled high blood pressure, heart disease, or liver disease, you should not take SNRIs unless cleared by a doctor. People with uncontrolled narrow-angle or angle-closure glaucoma should not take duloxetine or milnacipran, as they can increase the severity of glaucoma symptoms.
If you’re also treating an eating disorder, be aware that loss of appetite is a common side effect of SNRIs. Discuss treatment and approaches with your therapist before taking any SNRIs as well as what to do if you experience this side effect.
Warnings — SNRIs
Like other classes of antidepressants, SNRIs have an elevated risk of suicidal thoughts or suicidal ideation in younger patients. If this happens, discontinue your SNRI and reach out for medical help immediately.
Side Effects — SNRIs
The most common side effects of SNRIs as a class are nausea, dizziness and sweating. Sexual dysfunction is another possible side effect, particularly with duloxetine, venlafaxine, and desvenlafaxine.
Rarer side effects will depend on the specific medication and may include:
- Fatigue
- Constipation
- Insomnia
- Headache
- Appetite loss
Not all SNRIs will have the same side effects for all people, so you may be able to switch to another medication in the class.
Drug Interactions — SNRIs
Wait 14 days before taking an SNRI if you’ve taken any MAOI, including herbal supplements that may contain MAOIs. MAOIs can impact how drugs are metabolized, leading to higher concentrations for longer periods of time.
SNRIs should not be combined with any other antidepressants or other medications that affect serotonin or norepinephrine unless ordered by a doctor, and in some cases, under their supervision. Classes of drugs that may fall into this category include:
- Anticonvulsants
- Antiemetics
- Migraine medications
- Certain dyes, such as methylene blue, used in medical procedures
As SNRIs affect more than one neurotransmitter, taking street drugs on top of an SNRI is dangerous. Cocaine, MDMA (ecstasy), and LSD are particularly risky with SNRIs.
There may be some risks with consuming alcohol while taking SNRIs, although more research is needed. It’s recommended to reduce or end alcohol consumption while taking SNRIs.
Abnormal bleeding is a risk with SNRIs, and NSAIDs and analgesics should only be taken if cleared by a doctor.
Benzodiazepines
Benzodiazepines are depressants, a class of drugs that reduce brain activity. They enhance the effect of the neurotransmitter GABA and are also used for seizures and muscle spasms. When used for anxiety, they’re usually prescribed with an antidepressant and only on an as-needed basis or for a two- to four-week course.
Examples of benzodiazepines include:
- Alprazolam (Xanax)
- Bromazepam
- Chlordiazepoxide (Librium)
- Clonazepam (Klonopin)
- Diazepam (Valium)
- Lorazepam (Ativan)
- Oxazepam
- Temazepam
- Triazolam
Contraindications — Benzodiazepines
Because of their effect on the parasympathetic nervous system, people with breathing disorders should consult with their doctor before using benzodiazepines.
Liver toxicity, though rare, has been recorded, so people with liver concerns should proceed carefully with benzodiazepines.
People with addictions should not use benzodiazepines, as they can be habit-forming. People with major depression or personality disorders should not take benzodiazepines as they may increase the risk of suicidal thoughts or ideation.
Warnings — Benzodiazepines
Benzodiazepines can occasionally have “paradoxical” effects, such as aggression or disinhibition. These are rare but will need to be carefully monitored.
Benzodiazepines have a high risk of overdose, so only take them as directed.
Side Effects — Benzodiazepines
Common side effects include:
- Drowsiness
- Dizziness
- Lack of alertness
- Lack of coordination
- Decreased libido
More rarely, users may experience:
- Nausea
- Blurred vision
- Confusion
- Euphoria
- Depersonalization
Drug Interactions — Benzodiazepines
Some benzodiazepines may interact with contraceptives, antibiotics, antidepressants, and antifungal medications in the liver, extending their effects.
Benzodiazepines should not be taken with alcohol, opioids, or other depressants, as these substances increase the possibility of side effects and raises the risk of overdose and death.
Pregabalin
Sold under the brand name Lyrica, pregabalin inhibits calcium channels, which helps with the production of the GABA neurotransmitter. Unlike benzodiazepines, pregabalin doesn’t act on GABA or its processes itself, which reduces the risk of dependency and offers a lower incidence of side effects.
Contraindications — Pregabalin
People with breathing disorders should check with their doctor before using pregabalin, as they can be common in people with multiple risk factors. The effect of pregabalin during pregnancy is unclear, so it’s not recommended for people who are pregnant or could become pregnant. People with kidney disorders may be at risk of overdose. Pregabalin is generally expressed in the urine and can accumulate in the body in the absence of regular normal function.
Warnings — Pregabalin
Suddenly or rapidly discontinuing pregabalin may trigger withdrawal effects, and it should be tapered off according to a doctor’s instructions. This risk is low if the medication is taken at the recommended dosage.
Side Effects — Pregabalin
Common side effects of pregabalin include:
- Headache
- Dizziness
- Sleepiness
- Confusion
- Memory issues
- Loss of coordination
- Dry mouth
- Vision impacts
- Weight gain
Rarer and more serious side effects may include angioedema, a swelling under the skin similar to an allergic reaction, or an increased risk of suicidal thoughts or ideation.
Drug Interactions — Pregabalin
Pregabalin may interact with other depressants. such as alcohol, that act on the GABA neurotransmitter. ACE inhibitors can trigger or intensify side effects and should be used with pregabalin only under a doctor’s supervision. Thiazolidinediones and pregabalin in combination can increase fluid retention.
Buspirone
Buspirone activates serotonin receptors in the brain, helping with mood regulation. Unlike antidepressants, which prevent the reuptake of neurotransmitters, making them more available, buspirone encourages the brain to make use of neurotransmitters. As such, it’s used almost exclusively for anxiety disorders, although it may be paired with SSRIs to limit jaw spasm side effects.
Contraindications — Buspirone
People with liver or kidney disease, or who may be at risk of metabolic acidosis, should not take buspirone.
Warnings — Buspirone
The risk of overdose with buspirone is unclear and needs further study. The most likely scenario for dangerous overdose is when it’s taken with benzodiazepines, alcohol, or cocaine, so use of these while taking buspirone is not recommended. Buspirone hasn’t been studied extensively for pregnancy risk, so taking it during pregnancy or pre-pregnancy is cautioned against.
Side Effects — Buspirone
The most common side effects of buspirone include:
- Mood disorder, including nervousness, depression, anger, and confusion
- Sleep disorder, including insomnia
- Difficulty in paying or maintaining attention
- A fast heart rate (tachycardia)
- Chest, musculoskeletal, or abdominal pain
- Congestion and pain in the sinuses
- Tingling skin
- Blurred vision
- Coordination difficulties
- Tremors
- Cold sweats
- Rashes
- Gastrointestinal issues, including diarrhea, nausea, constipation, and vomiting
- Dry mouth
- Fatigue
Drug Interactions — Buspirone
Buspirone should not be taken together with any MAO inhibitor, as it may cause a dangerous increase in blood pressure. It also should not be combined with any medication that inhibits or induces activity in liver enzymes, as this could either limit its effectiveness or put you at risk of overdose.
Special Considerations — Buspirone
Buspirone will need to accumulate in the body to be fully effective, a process that can take up to four weeks. People with eating disorders should be aware that buspirone may trigger a relapse of their disorder on rare occasions.
Find the Best Price on Anxiety Medications With BidRX
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How BidRX works
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To find the lowest price, visit our anxiety medications page to get started. When you see how easy it is to get the best price, you’ll never go anywhere else for your medication.
