What are the best anti-anxiety medications?

Many people have success with anti anxiety medications, and other people have no success at all. Some people react badly to the drugs and get severe side effects, others find they don’t work, and others take an almost ethical stance that psychiatric medicine is wrong.

Drugs used to treat anxiety and panic attacks are normally either Selective Serotonin Re-uptake Inhibitors (SSRI) such as Prozac, Celexa, Lexapro etc, or Benzodiazapines such as Valium, Xanax, and Lorazepam. The former take several weeks to work while the latter normally take effect within an hour and can be used on an as needed basis (depending on your doctor’s advice!!). Nowadays doctors also prescribe Serotonin–norepinephrine reuptake inhibitors (SNRIs) for anxiety.

Do they Work?

Benzodiazepines definitely do work, with alprazolam (Xanax) of cited as the most effective. But they are VERY addictive and great care should be taken over using them. Beware that if you take them for any length of time you might have to taper off them. Benzodiazepine addiction is nasty. As for SSRIs and SNRIs opinion is somewhat divided over their efficacy. A meta analysis in 2010 concluded:

“The magnitude of benefit of antidepressant medication compared with placebo … may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.

This is referring to their treatment of depression and not anxiety. The evidence for their usefulness in treating anxiety is unclear.

Alternatives to Medication

There are natural alternatives which have not been fully studied so their efficacy is hard to assess. Both Tryptophan and 5-HTP have been suggested as worthwhile alternatives and might be worth exploring further.

Which Medications are Best?

There is no answer to that question. Some anti anxiety and anti panic attack drugs work well for some people and not others. It is a case of trusting in your healthcare providers knowledge and being prepared to experiment a little. Alternatively you could chose to tackle your anxiety or panic attacks through Cognitive Behaviour Therapy or by looking at underlying health conditions that can cause anxiety alone (Killing Anxiety From The Roots is all about this). Remember, drugs treat symptoms and not causes. Your end goal should be to be free of anxiety without having to rely on drugs.

Speak to your doctor about drugs and avoid the temptation cheap online pharmacies. I would say that unless your anxiety is acute or you suffer severe panic attacks you probably do not need heavy tranquillisers such as Xanax, Valium, Klonopin and the like. When you factor in the dangers of dependence and addiction you may as well give them a miss or use them extremely sparingly.

SSRIs on the other hand probably have an effect on general anxiety and worry. They are thought to lift mood through increasing your level of the neurotransmitter Serotonin and the results for anxiety sufferers varies from a dramatic cessation of symptoms to mild relief. It should be said that a sizable number of anxiety sufferers get no benefit from SSRIs or find the side-effects to much to handle.

People often ask which anti-anxiety medication is best. The answer is that every drug and pill works differently for different people so that question can not be answered. I was once told by a highly accomplished therapist that Lexapro (escitalopam) was the best only to meet the same day a doctor who refused to prescribe it, insisting that Celexa (citalopam) was the only way forward. It is generally accepted that Paxil (paroxetine), also known as Seroxat, id one of the hardest SSRI meds to quit due to it’s half life.

The bottom line is: talk to your doctor and make sure drugs are not your only defence against anxiety, panic attacks, and depression. You need to tackle underlying causes as well. And don’t try and use over the counter medication or drugs to tackle anxiety and panic, it won’t work and some of that stuff can be dangerous if taken repeatedly.


The Drugs for Anxiety section is here.

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