Medical Review by DeAnna McGarity MD
Summary
- Anxiety medications like Selective Serotonin Reuptake Inhibitor
- Consulting a healthcare professional is essential for managing anxiety medication safely and appropriately.
- Escitalopram (Lexapro®), Fluoxetine (Prozac®), and Sertraline (Zoloft®) are common SSRIs with specific characteristics and side effects, whereas Bupropion (Wellbutrin®) is a popular NRDI.
- Lifestyle changes and therapy may also enhance the effectiveness of your anxiety treatment.
Anxiety is a common condition in the United States, experienced by approximately 34% of adults at some point in their lives. It can be triggered by a wide variety of different objects or situations, leading to intense feelings of discomfort and affecting your behavior in ways that can interfere with relationships and daily life.
Anxiety medications target the neurotransmitters in the brain that influence mood and stress levels. They help balance the levels of naturally-occurring chemicals like serotonin, norepinephrine, and dopamine, which may not be present at normal levels if you have an anxiety disorder.
Understanding the different options to medicate anxiety can help you work with your healthcare provider to make an appropriate decision that supports your mental health.
At Lemonaid Health, we offer online anxiety treatments that may include virtual consultations with qualified medical practitioners and medication if clinically indicated.
Anxiety medications: SSRIs vs NRDIs
SSRIs vs. NRDIs
Two popular types of medication for treating anxiety include selective serotonin reuptake inhibitors (SSRIs) and norepinephrine-dopamine reuptake inhibitors (NRDIs). Each of these medication types focuses on increasing the levels of different chemicals in the brain to influence your mood. Here’s a quick overview of both:
- SSRIs help improve your mood and reduce anxiety by increasing serotonin levels in the brain. They do this by preventing serotonin from being reabsorbed after it has been produced, which raises overall levels.
- NRDIs increase the levels of norepinephrine and dopamine (neurotransmitters associated with alertness and pleasure). They offer an alternative approach for people who may not respond to SSRIs or have other medical conditions.
Consulting healthcare professionals about anxiety medication
Choosing the right medication for anxiety varies from one person to the next. It’s a highly personal decision that you should always make with a qualified health practitioner.
Healthcare professionals often consider the following factors before prescribing anxiety medication (this may also require a review of your medical history):
- The efficacy of available medications
- Potential adverse effects
- Potential drug interactions
- Costs and patient preferences
Only a qualified healthcare provider can help you weigh these factors properly to find an effective solution. Never self-prescribe medication for anxiety or other mental health conditions.
Anxiety medication list
Before taking any medication, you should discuss all potential side effects with your healthcare provider. You can also refer to the patient information to see a complete list of potential side effects. There are a lot of choices available, particularly within SSRIs each beneficial for different psychiatric illnesses.
Escitalopram (Lexapro®)
Escitalopram is commonly known by the brand name Lexapro®. It is an SSRI that is FDA approved for treating generalized anxiety disorder in adults and children over seven years old. It’s also commonly used to treat depression.
Notable characteristics
Here are a few key facts to know about Escitalopram before discussing it with your healthcare provider:
- Eating food doesn’t affect the way it absorbs into your bloodstream
- It’s less likely to interact with drugs that bind to proteins
- It’s usually taken once per day, with or without food
Potential side effects & considerations for usage
Escitalopram is effective for many patients, but it can cause side effects. Some people taking Escitalopram may experience:
- Nausea
- Sleepiness
- Weakness
- Dizziness
- Feeling anxious
- Trouble sleeping
- Sexual problems
- Sweating
- Shaking
- Loss of appetite
- Dry mouth
- Constipation
- Infection
- Yawning
- Serotonin Syndrome
- Suicidal thinking and behavior
Fluoxetine (Prozac®)
Fluoxetine is known by the brand name Prozac®. It is another SSRI commonly used to treat anxiety, depression, and other mood disorders.
Fluoxetine works by blocking the reabsorption of serotonin in the brain, which can help improve communication between your nerve cells and stabilize your mood.
Notable characteristics
Here are some quick facts about fluoxetine to know before bringing it up with your healthcare provider:
- Eating food won’t impact its effectiveness
- It stays in the body for several weeks
- You’ll usually take it once daily in the morning or evening
Potential side effects & considerations for usage
As with other anxiety medications, fluoxetine has potential side effects. Some of the more common ones include:
- Unusual dreams
- Sexual problems
- Loss of appetite
- Diarrhea
- Indigestion
- Nausea or vomiting
- Weakness
- Dry mouth
- Flu symptoms
- Feeling tired or fatigued
- Changes in sleep habits
- Yawning
- Sinus infections or a sore throat
- Tremors or shaking
- Sweating
- Feeling anxious or nervous
- Hot flashes
- Rash
- Serotonin syndrome
- Suicidal thinking and behavior
Sertraline (Zoloft®)
Sertraline is marketed under the brand name Zoloft®. This SSRI is effective in treating anxiety, depression, and other mood disorders. In addition to increasing serotonin levels, sertraline also allows for greater dopamine release than other SSRIs.
Notable characteristics
Before talking about it with your healthcare provider, consider these facts about sertraline:
- Sertraline may be absorbed more effectively when taken with food
- It’s usually taken once daily
- You can take it in either the morning or the evening
Potential side effects & considerations for usage
There are also several potential side effects of sertraline. The most common of these include:
- Nausea
- Loss of appetite
- Diarrhea
- Indigestion
- Changes in sleep habits (including increased sleepiness or insomnia)
- Increased sweating
- Sexual problems (including decreased libido and ejaculation failure)
- Tremors or shaking
- Feeling tired or fatigued
- Agitation and anxiety
- Serotonin Syndrome
- Suicidal thinking and behavior
Bupropion (Wellbutrin®)
Bupropion is sold under the brand name Wellbutrin®. This is a type of NDRI that helps prevent norepinephrine and dopamine from being reabsorbed too quickly after they are produced in your brain.
Notable characteristics
Here are some facts about bupropion to know if you’re considering taking it for anxiety:
- Can be taken with or without food
- Taken orally in either regular or extended-release forms
- Has a duration of action of 1 to 2 days
Potential side effects & considerations for usage
Just like the SSRIs mentioned previously, NDRIs like Bupropion can have side effects. The most common potential side effects of bupropion include:
- Nervousness
- Constipation
- Trouble sleeping
- Dry mouth
- Headaches
- Nausea
- Vomiting
- Shakiness (tremors)
- Suicidal thinking and behavior
- Seizures
Monitoring & adjusting medications
Professional observation is strongly recommended before switching or adjusting any antidepressant medications—including SSRIs and anxiety medications. Checking in with your healthcare provider on a regular basis helps ensure that your medication is effective and makes it easier to address any side effects quickly.
If you begin taking medication for anxiety, be sure to schedule follow-up appointments with your healthcare provider. This will give you opportunities to discuss your progress, any side effects, and the medication’s overall effectiveness.
Based on your responses, your healthcare provider may decide to adjust your dosage. If your current medication isn’t effective or causes unwanted side effects, they may recommend switching to another medication. Do not adjust your medication by yourself.
Lifestyle & behavioral support for anxiety
Medication is not the only thing that can help you reduce anxiety symptoms. A variety of research suggests that lifestyle and behavioral changes can aid medication in reducing symptoms and helping with long-term management:
- Regular exercise has been linked to reduced anxiety in clinical settings.
- Healthy eating patterns have been linked to reduced anxiety symptoms.
- Improving the quality of your sleep may significantly reduce anxiety levels.
- Mindfulness meditation training can reduce anxiety symptoms in patients with generalized anxiety disorder.
Other holistic approaches to anxiety management
Combining medication with therapy may also help support your anxiety treatment.
There are several forms of psychotherapy used to provide support and attention for the underlying emotional problems that often come with anxiety. Some of the most common ones include:
- Cognitive Behavioral Therapy (CBT): This aims to help you identify and change negative thought patterns and behaviors.
- Exposure Therapy: By gradually exposing you to situations or objects that cause fear, this type of therapy aims to make you less avoidant and reduce your anxiety symptoms.
- Psychodynamic Therapy: This focuses on exploring past experiences and emotional patterns so that you can understand your anxiety on a deeper level and resolve the underlying causes.
These methods may also be used independently of medication (although the research cited above shows higher effectiveness from combining therapy with medication).
Working with professionals to treat and manage anxiety
Anxiety is common, but appropriate medication and other strategies can help reduce its impact on your life. If you believe that you or someone you know is experiencing anxiety, reach out to a healthcare provider as soon as possible.
Lemonaid Health provides online anxiety treatment including virtual consultations with qualified medical practitioners and prescriptions for FDA-approved medication if clinically indicated. Learn more about our services so that you can decide on how to move forward with confidence.
Lexapro® is a registered trademark of Allergan, Inc. Prozac® is a registered trademark of Eli Lilly & Company. Zoloft® is a registered trademark of Pfizer, Inc. Wellbutrin® is a registered trademark of GlaxoSmithKline LLC
