Medication can help you conquer anxiety—but which one is best for you?
You’ve tried everything you can think of to beat your anxiety—from therapy to yoga to jogs in the park. But nothing seems to help.
“The research is clear,” says Colleen Cira, Psy.D., a licensed clinical psychologist and director of the Cira Center for Behavioral Health. “A combination of therapy and medication can be the most effective way to treat anxiety. But if you’re stuck, it may be time to reach out to your doctor.”
Be cautious though. Medication shouldn’t be your first approach. The most effective treatment for anxiety disorders is cognitive behavioral therapy (CBT). In fact, lots of anxiety problems can be addressed without meds.
However, if you opt for medications, how do you know which one is right for you? There are dozens of antianxiety meds. Here are some things to know to help you—and your doctor—make the best choice.
But first, ask about being tested with the Genomind Professional PGx, a genetic test that can help your clinician understand if a particular drug is more or less likely to work for you—or, conversely, more likely to be poorly tolerated.
This can help get you on the right medication sooner and help you avoid the trial and error that often comes with figuring out the best drugs for anxiety.
There are fast-acting meds that can calm you down when you’re having a panic attack or help you board a plane when you’re terrified to fly. Some examples:
- Alprazolam (Xanax)
- Clonazepam (Klonopin)
- Diazepam (Valium)
- Lorazepam (Ativan)
These drugs, called benzodiazepines, work by supercharging GABA—the neurotransmitter, or chemical messenger, that reduces activation in neurons all over the body. That boost of GABA slows down the amygdala (the part of your brain that detects danger and gets you pumped up to face emergencies), as well as the responses it creates, like a pounding heartbeat, sweating, or the impulse to run or fight.
Benzos, as they’re known, have a tranquilizing effect on your amygdala. They can help slow the amygdala down, but they also keep it from learning new ways to respond, so they don’t correct the situation.
Your doctor might prescribe benzos as the quickest treatment, but they are not best for long-term use. Running around the block and deep slow breathing may work faster at calming the amygdala.
But be very careful: Benzos can’t be used on a daily basis without a lot of risk. If you take them regularly, they’re likely to become habit-forming, and they’re among the toughest drugs to quit.
SSRIs and SNRIs
You’ve probably heard of drugs like Zoloft and Cymbalta. They’re usually known as antidepressants, but it turns out they can help with anxiety too. They work by targeting serotonin or norepinephrine—two of the neurotransmitters that carry signals from one brain cell, or neuron, to the next.
They take a few weeks to kick in, but when they do, they prevent those chemicals from being reabsorbed into the neuron. That keeps them in the synapse, the tiny space between your neurons, for a longer time. And when that is maintained for about a week or so, your neurons begin to change. These drugs make your neurons more flexible. Your brain begins to restructure itself, making it easier for you to learn new things.
SSRIs (selective serotonin reuptake inhibitors) target the neurotransmitter serotonin, while SNRIs (or serotonin and norepinephrine reuptake inhibitors) target both serotonin and norepinephrine.
Scientists think that SSRIs and SNRIs help rewire the circuits of your brain responsible for fear and anxiety. When those meds are combined with therapy, studies show that the results are often better—and quicker—than therapy alone.
Some examples of these medications:
- Sertraline (Zoloft)
- Citalopram (Celexa)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Venlafaxine (Effexor XR)
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
These drugs aren’t addictive, but they may have some uncomfortable side effects, like dry mouth, drowsiness, and headaches. One thing to look out for: Some people experience discontinuation symptoms when quitting abruptly. If you decide to stop, make sure you cut back slowly, with your doctor’s guidance.
Beta blockers are designed to treat heart disease and high blood pressure—but sometimes doctors prescribe them “off-label” to treat anxiety.
They work by blocking the effects of norepinephrine—a neurotransmitter that triggers the fight-or-flight response. If you’re having an anxiety attack, you’ve got lots of norepinephrine pumping through your body, making your heart beat faster, your palms sweat, and your head feel a little dizzy. Beta blockers can help you take all of that down a notch.
They don’t “cure” anxiety, but they can help lessen the physical symptoms, especially when you’re unusually nervous, like before a big presentation.
Some of the beta blockers used to treat anxiety off-label:
- Propranolol (Inderal)
- Atenolol (Tenormin)
Beta blockers aren’t addictive, but they may have some side effects, like dizziness, breathing problems, and nausea. And you should not stop taking them suddenly, as that could be dangerous.
Disclaimer: Genomind does not endorse certain medications for the treatment of anxiety. All medication should be taken under a clinician’s care. Do not discontinue use without your doctor’s permission.