Medications for Anxiety and Depression (2024)

Anxiety and depression are common but serious mental health issues that can cause a dramatic decrease in functioning and quality of life. In the United States, about 1 in 5 people experience anxiety, and 1 in 10 have depression.

Symptoms of anxiety includethe following:

  • Excessive worry
  • Avoidance behavior
  • Panic attacks

Symptoms of depression include the following:

  • Sadness
  • Fatigue
  • Inability to feel pleasure (anhedonia)
  • Impaired mental function

Both genetic and environmental factors can contribute to anxiety and depression. Some of the causes of these disorders overlap, includingthe following:

  • Family history of depression
  • Low self-esteem
  • Childhood abuse
  • Traumatic experiences

Here's what you need to know about treatment options for anxiety and depression.

What to Do If You're Feeling Depressed or Anxious

If you or a loved one is struggling with anxiety or depression, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-4357for information on support and treatment facilities in your area.

If you have suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one is in immediate danger, call911.

For more mental health resources, see ourNational Helpline Database.

What Medications Are Available for Anxiety and Depression?

There are several classes of medications used to treat anxiety and depression. The drugs in these classes work by increasing the activity of chemical messengers (neurotransmitters) that are involved in mood regulation, such as:

  • Serotonin
  • Norepinephrine
  • Dopamine
  • Gamma-aminobutyric acid (GABA).

The right medicine for you depends on your symptoms, other medications you take, and how severe your anxiety or depression is.

Antianxiety MedicationsMedications for Anxiety and Depression (1)

Often, healthcare providers select a medication with side effects that can improve your symptoms. For example, an antidepressant that causes weight gain may be a good choice for someone with depression who is also experiencing reduced appetite and weight loss.

AntidepressantsMedications for Anxiety and Depression (2)

Here's a summary of the most common medications for anxiety and depression.

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Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) increase serotonin levels. They are typically the first choice for people with the following conditions:

  • Depression
  • Anxiety disorders like generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder
  • Both depression and anxiety

Side Effects

The most significant side effects of SSRIs are:

  • Sexual dysfunction, which occurs in over 80% of people who take SSRIs
  • Headache
  • Long QT sydrome or QTc prolongation (heart's electrical system takes longer to recharge between heartbeats)
  • Weight gain
  • Brain bleeds


Typical doses of common SSRIs, which, unless otherwise specified, treat both anxiety and depression, include:

  • Celexa (citalopram): 20 to 40 milligrams (mg) daily
  • Lexapro (escitalopram: 5 to 20 mg daily for depression; 10 to 20 mg daily for anxiety
  • Paxil (paroxetine): 20 to 40 mg daily for depression; 20 to 60 mg daily for anxiety
  • Zoloft (sertraline): 50 to 200 mg daily
  • Prozac (fluoxetine): 20 to 60 mg daily

Medications for Anxiety and Depression (3)

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Serotonin-norepinephrine reuptake inhibitors (SNRIs) increase levels of both serotonin and norepinephrine. They are typically prescribed first for people with the following conditions:

  • Depression plus chronic pain
  • Severe depression
  • Anxiety disorders, including GAD, social anxiety disorder, or panic disorder

Antidepressant effects of SNRIs may be seen earlier than with SSRIs.

Side Effects

Adverse effects of SNRIs includethe following:

  • Headache
  • High blood pressure (hypertension)
  • Excessive sweating


Typical doses of SNRIs to treat depression or anxiety are:

  • Effexor (venlafaxine): 75 to 375 mg daily for depression or anxiety
  • Pristiq (desvenlafaxine): 25 to 50 mg daily for depression; 50 to 100 mg daily for anxiety
  • Cymbalta (duloxetine): 30 to 60 mg daily for depression or anxiety
  • Savella (milnacipran): 12.5 to 100 mg daily for depression
  • Fetzima (levomilnacipran): 20 to 120 mg daily for depression

Tricyclic Antidepressants (TCAs)

Like SNRIs, tricyclic antidepressants (TCAs) increase levels of serotonin and norepinephrine. They are most helpful for people with the following conditions:

  • Depression plus pain due to fibromyalgia, nerve pain, or irritable bowel syndrome
  • Severe depression
  • Anxiety disorders like GAD or panic disorder

TCAs should be used with caution in people who have heart disease.

Side Effects

Side effects of TCAs includethe following:

  • Dry mouth
  • Constipation
  • Inability to urinate (urinary retention)
  • Dizziness when standing (orthostatic hypotension)
  • Seizures
  • Weight gain
  • Irregular heartbeat (arrhythmia)

TCAs are particularly dangerous in overdose situations. If you or a loved one has taken too much of a TCA, seek medical help immediately.


Although this class of drugs is prescribed off-label for anxiety—meaning TCAs are not approved by the Food and Drug Administration (FDA) to treat anxiety but have been proven to help the condition—typical doses of TCAs prescribed for anxiety and depression include the following:

  • Elavil (amitriptyline): 50 to 200 mg daily for depression
  • Pamelor (nortriptyline): 25 to 150 mg daily for depression; 50 to 150 mg daily for anxiety
  • Tofranil (imipramine): 75 to 150 mg daily for depression; 100 to 300 mg daily for anxiety
  • Norpramin (desipramine): 100 to 300 mg daily for depression; 100 to 200 mg daily for anxiety
  • Anafranil (clomipramine): 100 to 250 mg daily for anxiety

Monoamine Oxidase Inhibitors (MAOIs)

Monoamine oxidase inhibitors (MAOIs) were the first antidepressants discovered in the 1950s. They increase serotonin, norepinephrine, and dopamine levels by blocking an enzyme that breaks down these chemical messengers.

Some serious side effects and interactions with other medicines limit their use. Although they aren't used often, MAOIs can be good choices for treatment-resistant depression (when other medications have failed).

Side Effects

MAOIs may cause the following side effects:

  • Hypertensive crisis
  • Weight gain
  • Sexual dysfunction
  • Serotonin syndrome (a buildup of serotonin levels in the body), especially if taken at high doses or with other medicines that increase serotonin levels

Serotonin syndrome can be life-threatening. The following symptoms characterize serotonin syndrome:

  • Agitation
  • Sweating
  • High heart rate (tachycardia)
  • Nausea or vomiting
  • Seizures
  • Stiff muscles
  • Dilated pupils

MAOIs are the main drug class associated with serotonin syndrome, so if you take one of these medications, watch for any of these effects. These are signs of an emergency, so go to your nearest emergency room or call 911 if you experience any of them.


Typical doses of MAOIs for depression or anxiety are:

  • Marplan (isocarboxazid): 20 to 60 mg daily for depression
  • Nardil (phenelzine): 45 to 90 mg daily for depression; 30 to 90 mg daily for anxiety
  • Emsam (selegiline patch): 6 to 12 mg applied to the skin every 24 hours for depression


Benzodiazepines (sometimes referred to as benzos) are controlled substances that are also used for seizures and muscle spasms. They increase the effects of GABA and can help treat anxiety but not depression.

Benzos have a rapid onset of action (they start acting quickly). They are typically used only as needed or as a bridge until antidepressants like SSRIs or SNRIs kick in.

Side Effects

Side effects associated with benzos include:

  • Dependence or drug use disorder
  • Respiratory depression (slow breathing)
  • Sedation


Benzodiazepines are not used for depression, but may be used to treat anxiety at the following doses:

  • Klonopin (clonazepam ): 1 to 2 mg daily
  • Xanax (alprazolam): 1 to 4 mg daily
  • Ativan (lorazepam): 2 to 6 mg daily
  • Librium (chlordiazepoxide): 20 to 100 mg daily
  • Serax (oxazepam): 30 to 60 mg daily


Beta-blockers are traditional heart medications. One of them, propranolol, is sometimes used off-label for performance anxiety (stage fright) or post-traumatic stress disorder (PTSD).

In low doses, propranolol can counteract the adrenaline rush that causes symptoms of stage fright, such as shaking and high heart rate. Overall, though, there's not much evidence to support using beta-blockers like propranolol for anxiety, and they are not appropriate treatments for depression.

Side Effects

Side effects of propranolol includethe following:

  • Dizziness
  • Fatigue
  • Slow heart rate
  • Low blood pressure
  • Rash
  • Bronchospasm (wheezing)
  • Heart failure


Propranolol at doses of 60 to 120 mg daily is used off-label for anxiety.

Atypical Antidepressants

Atypical antidepressants work by different pathways to increase dopamine or norepinephrine in the body. They are a good choice for people who have sexual dysfunction or other side effects related to the use of SSRIs or SNRIs.

Side Effects

Because medicines in this "catch-all" class aren't structurally related, side effects vary. Significant side effects associated with atypical antidepressants include:

  • Seizures with bupropion
  • Weight gain and sleepiness with mirtazapine
  • Liver toxicity with agomelatine

Note that bupropion should not be taken by people with seizure disorders or a history of seizures.


Here are the typical doses used for these atypical antidepressants.

  • Wellbutrin (bupropion): 150 to 300 mg daily
  • Remeron (mirtazapine): 15 to 45 mg daily for depression or anxiety
  • Valdoxan (agomelatine): 25 to 50 mg daily for depression

Other Interventions

Depending on the severity of your anxiety or depression, other interventions may be helpful alone or in conjunction with medications. These interventions include:

  • Exercise: Exercise has been proven to be as effective as antidepressants or psychotherapy for mild or moderate depression and to augment the effects of other treatments on severe depression. The most significant benefit is seen with aerobic exercise (often called cardio). And while there are fewer studies of exercise's effects on anxiety, it seems to be about as effective as other treatments.
  • Cognitive behavioral therapy (CBT): In people who are depressed, CBT involves replacing negative thoughts and distortions with helpful techniques to improve mood. It can enhance the effects of antidepressants and lower the risk of relapse. CBT also has modest benefits for people with anxiety, especially those with obsessive-compulsive disorder (OCD), GAD, or acute stress disorder.
  • Meditation: There's not enough evidence to recommend meditation as the only treatment for anxiety or depression. That said, focusing on mindfulness is helpful for people with depression, and benefits can last up to six months. There isn't as much data supporting meditation for people with anxiety.
  • Yoga: This intervention is best as an add-on to conventional treatments for people with depression or panic disorder. Even just one hour-long session per week has been shown to reduce symptoms.

Discussing your mood and any symptoms you may have with your healthcare provider before self-treating is essential. This will ensure that you are getting all the help you need.

Nutrition Considerations

Herbal supplements that have been studied for anxiety and depression includethe following:

  • Kava
  • Cannabidiol (CBD)
  • Ashwagandha
  • Lavender
  • Chamomile
  • Black cohosh
  • Saffron
  • Omega-3 fatty acids
  • Magnesium
  • Saint-John's-wort

Saint-John's-wort interacts with many medications. Before trying these or any other supplements, discuss them with your healthcare provider to ensure they don't interact with any other medications you may be taking. These are not safe choices for everyone.

Supplements that increase serotonin levels shouldn't be taken with SSRIs or SNRIs due to the risk of serotonin syndrome. A few of these supplements includethe following:

  • Tryptophan
  • Saint-John's-wort
  • 5-Hydroxytryptophan (5-HTP)


Anxiety and depression are mental health disorders typically requiring treatments like antidepressants or psychotherapy.

Medications used for anxiety and depression are associated with side effects like sexual dysfunction, weight gain, and headaches. And they may take two to three weeks to see the effects. If you are experiencing side effects or not seeing improvement from your treatment, discuss this with your healthcare provider. Never stop taking antidepressants abruptly, as this could cause your symptoms to worsen.

Additional interventions that help depression or anxiety include CBT and meditation. The combination of antidepressants, psychotherapy, exercise, and good nutrition can be even more effective than medication alone.

Frequently Asked Questions

  • What medication is best for anxiety and depression?

    SSRIs are the most effective medicines for treating both anxiety and depression and usually are the first prescribed. They are even more effective when combined with therapy.

  • What is the most recommended drug for anxiety?

    Many anxiety disorders, including GAD, social anxiety disorder, and panic disorder, are first treated with SSRIs or SNRIs.

    A review of 41 clinical trials showed that Cymbalta (duloxetine) and Lexapro (escitalopram) are the most effective medicines for adults with GAD.

    Because SSRIs and SNRIs may take a few weeks to reach full effect, sometimes benzodiazepines are also given until the antidepressants kick in.

  • What is the safest antidepressant for anxiety?

    All antidepressants have side effects. That said, newer classes of medicines like SSRIs and SNRIs have less severe side effects than older ones like TCAs and benzos.

  • How can I reduce stress?

    There are many ways to manage stress, including getting enough sleep, asking for help, eating well, exercising, practicing meditation or yoga, and getting cognitive behavioral therapy.

    Sometimes, stress can be overwhelming and challenging to manage on your own. Try to seek medical help if you feel overwhelmed or hopeless. You are not alone.

    Contact theSAMHSA National Helplineat800-662-4357for information on support and treatment facilities in your area if you are struggling with anxiety.

Medications for Anxiety and Depression (2024)


Medications for Anxiety and Depression? ›

SSRIS (selective serotonin reuptake inhibitors), like Zoloft (sertraline), Prozac (fluoxetine), and Lexapro (escitalopram), and SNRIs (serotonin and norepinephrine reuptake inhibitors), such as Effexor (venlafaxine) and Cymbalta (duloxetine), are widely prescribed for both anxiety and depression.

What is the 333 rule for anxiety? ›

It's an easy technique to remember and use in the moment, it's available to us the majority of the time, and it can be a simple strategy to help us focus and ground when anxiety overwhelms. Put simply, you name three things you can see, three you can hear, and move three different body parts.

What is the highest rated antidepressant for anxiety? ›

6 most effective antidepressants sold in the United States
  • Amitriptyline.
  • Effexor (venlafaxine)
  • Lexapro (escitalopram)
  • Paxil (paroxetine)
  • Remeron (mirtazapine)
  • Trintellix (vortioxetine)

Which anxiety disorder is hardest to treat? ›

Generalized anxiety disorder (GAD) is characterized by persistent and excessive worry. Around half of the patients treated for GAD will fail to respond to initial treatment.

What is the biggest problem with antianxiety drugs? ›

They are addictive.

Benzodiazepines are generally prescribed for short-term use. If people take these medications frequently or continue to use them for longer than recommended, they face an increased risk of addiction.

What is the 80 20 rule anxiety? ›

80 per cent of your anxious thoughts might be about 20 per cent of issues, so next time the anxious feeling comes up, stop and ask yourself why you're thinking about this now.

What are the 3 C's of anxiety? ›

The Three C's for Anxiety. When it comes to coping with anxiety, the three C's - Calm Techniques, Coping Strategies, and Communication Skills - can be powerful tools in managing and reducing anxiety symptoms.

What is the best pill for severe anxiety? ›

The most prominent of anti-anxiety drugs for the purpose of immediate relief are those known as benzodiazepines; among them are alprazolam (Xanax), clonazepam (Klonopin), chlordiazepoxide (Librium), diazepam (Valium), and lorazepam (Ativan).

Is there a medication that treats both depression and anxiety? ›

Zoloft (sertraline)

Zoloft is another SSRI antidepressant that can also treat depression and certain types of anxiety.

Is Zoloft or Lexapro better for anxiety? ›

A 2014 study published in International Clinical Psychopharmacology suggested that Lexapro may be more effective and better tolerated than Zoloft or Paxil. Lexapro has different binding site interactions which may lead to better efficacy and tolerability.

What is one of the hardest mental illness to live with? ›

Borderline personality disorder is one of the most painful mental illnesses since individuals struggling with this disorder are constantly trying to cope with volatile and overwhelming emotions.

Why is my anxiety so bad even with medication? ›

There may be several reasons why an anxiety medication is not working. A patient may have co-morbid conditions or they may not be taking the medication as prescribed. Or, anxiety symptoms may be due to an underlying and untreated biological cause, such as a bacterial or viral infection.

What drug makes anxiety worse? ›

However, drugs like cocaine, lysergic acid diethylamide (LSD), methamphetamine, and phencyclidine (PCP) can sometimes have the opposite effect. They can cause hallucinations, fast heart rates, and other side effects that cause anxiety or worsen an anxiety condition.

What is a drug that calms you down? ›

Benzodiazepines are also called minor tranquillizers, sedatives or hypnotics. They are the most widely prescribed psychoactive drugs in the world. The calming effects of benzodiazepines can often be achieved without drugs.

Why you shouldn't take medication for anxiety? ›

Suicide Risk and Antidepressants

This is because some have led to an increased risk of suicidal thoughts and behaviors in teens and young adults. In a 2015 study of 238,000 adults ages 20 to 64, researchers found that those taking mirtazapine, venlafaxine, or trazodone were more likely to attempt suicide or self-harm.

What is the number one way to get rid of anxiety? ›

Natural strategies like regular physical activity, aromatherapy, deep breathing, mindfulness, and chamomile tea may help you reduce anxiety symptoms. If you feel your anxiety is getting worse, consider professional help. Talk therapy, prescription medication, or both, may help with severe or persistent anxiety.

What are the 3 P's of anxiety? ›

The 3 P's stand for Pervasiveness, Permanence and Personalisation. Pervasiveness looks at how much of your life a concern impacts – How big? Permanence looks at how long an issue is going to be of concern – How long? Personalisation looks at how much you feel you are to blame – How much?

What are the four C's of anxiety? ›

More specifically we expect positive association between caring and anxiety and a negative association between the other four Cs (competence, confidence, character, and connection) and anxiety.

What is the 5 5 5 rule for anxiety? ›

First, you may want to start with a simple deep breathing exercise called the 5-5-5 method. To do this, you breathe in for 5 seconds, hold your breath for 5 seconds, and then breathe out for 5 seconds. You can continue this process until your thoughts slow down or you notice some relief.


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