Medically reviewed by Angela Sheddan, DNP, FNP-BC
Written by Our Editorial Team
Last updated 7/12/2021
On really bad days, anxiety sufferers can feel a certain level of desperation.
When anxiety becomes immobilizing, there’s a sense of “I’ll do anything,” to get rid of the symptoms.
Anxiety is a difficult disorder to live with, and a difficult one to treat, so if you’ve ever felt that way, you’re not alone.
The search for a “cure” can lead you down internet rabbit holes to herbs and supplements, not to mention a dizzying array of prescription medications. It can be overwhelming just to try and figure out what to take to regulate those feelings of being overwhelmed.
So, what works? Is there a magic pill for anxiety?
Whether you’re looking at prescription options for your anxiety, or searching for an over-the-counter antidote for your symptoms, there are some important things you need to understand about anxiety before you go grabbing bottles off the shelves.
The best place to start is with anxiety itself.
According to the National Institute of Mental Health (NIMH), anxiety disorders are a group of conditions defined by intense feelings of anxiety, unease or panic.
Many versions of anxiety disorder can have overlapping symptoms, including more severe senses of panic — and panic sufferers may experience anxiety, too.
Anxiety symptoms include restlessness, muscle tension, difficulty sleeping, feeling on edge or wound-up, difficulty concentrating, fatigue, irritability and uncontrollable worry.
But one bad night does not make a diagnosis. Typically, those anxiety symptoms are felt most days for at least six months.
These feelings, by the way, are common: more than 30 percent of American adults experience an anxiety disorder at some point in their lives.
Generalized anxiety disorder, or GAD, is defined by an extended period of excessive anxiety or worry — months, years or more.
Anxiety is caused by imbalances of chemicals in the brain, similar to depression and other mood disorders.
While there is no “cure,” we do have ways of addressing the symptoms of anxiety, including anxiety medications.
There are a variety of medications available for anxiety, including prescription and over-the-counter options.
While prescriptions carry the largest volume of evidence to back up their efficacy, some OTC options also deserve your attention. Let’s take a look at these first.
There are a number of herbal and natural supplements that can be acquired over the counter, or even from your local grocery store aisle.
Not all herbal supplements can deliver on their promises, but the following ones have proven some degree of efficacy, according to research.
Passionflower has centuries of folk medicinal use for anxiety in its history, but it also has decades of study history to back that up.
One study showed benefits for Generalized Anxiety Disorder sufferers, with lower impairment compared to benzodiazepine (though benzodiazepine was more effective).
The drink kava has been used for centuries to treat insomnia and restlessness.
It manages to do this without being a sedative or creating impairment.
Scientists believe kava may work to block norepinephrine and dopamine reuptake.
Derived from a perennial shrub, St. John’s wort is a natural medication licensed in some countries to treat anxiety and sleep disorders.
It is most recognized for its depression-specific benefits — one trial in Germany found it was as effective as imipramine in treating mild to moderate depression.
Other studies have been less promising, suggesting that milder cases won’t see results from St. John’s wort treatment.
Science has shown a correlation between magnesium and reduced anxiety symptoms, but the mechanism hasn’t been fully understood.
It’s possible that its benefits are simply the result of better health due to multivitamin usage, though further study is needed.
Treating anxiety with prescription medication is a complicated process. Generally speaking, the go-to solution these days is actually antidepressants which, in many cases, offer anti-anxiety benefits as on-or-off label secondary benefits.
Other medications lack sufficient research, sedate rather than treat, or take another approach altogether.
Of the prescriptions on the market, the default is selective serotonin reuptake inhibitors, or SSRIs.
Other medications are generally only considered if SSRIs fail to do the job. Other medications prescribed for anxiety include:
A cousin of SSRIs, SNRIs similarly regulate brain chemicals, though these specialize in a brain chemical called norepinephrine, which is both a neurotransmitter and a stress hormone.
Drugs like duloxetine and venlafaxine fall into this category.
They have a similar effect to SSRIs, and are often effective when SSRIs fail.
A drug predominantly used to treat nerve pain, pregabalin is also approved for the treatment of anxiety, and specifically of generalized anxiety disorder.
Pregabalin has been shown effective in several studies, but its side effects include dizziness and feeling tired, which can make it less effective for people looking for a medication that helps them function normally.
This group of drugs collectively boasts potential for future anxiety treatment efficacy, but unfortunately, they’ve not been thoroughly studied.
Of the three, buspirone is the most readily employed, particularly if SSRIs aren’t well tolerated.
Hydroxyzine is actually an antihistamine with anti anxiety properties, but its side effects include drowsiness, which can lessen its benefits for people trying to perform normal functions.
Benzodiazepines aren’t medications to control anxiety, but rather sedatives that relieve anxiety symptoms.
They’re effective, but at the risk of dependency after just a few weeks.
They may be more effective for acute anxiety, but are not recommended for generalized anxiety disorder.
Pills aren’t the only way out of the anxiety hole — in fact, they’re only part of the typical escape plan.
Our guide to coping with anxiety explores treatment options on the market today, but for now, there are a few we’d like to highlight.
The first is therapy.
Therapy isn’t a cure for anxiety disorders, but it does create an effective foundation for talking about the symptoms and building a plan for dealing with them day to day.
CBT helps disorder sufferers recognize disordered thinking patterns that may let anxiety stay in the driver’s seat.
CBT can help you understand those negative patterns, and can offer you coping strategies to mitigate future attacks.
We’ve talked more about CBT in our guide, What Is Psychotherapy & How Does It Work?.
If you happen to speak with a healthcare professional about your anxiety, they may also consider lifestyle, career, relationships and other factors that may be contributing to issues.
Diet, exercise and substance abuse may be making things worse, and addressing those concerns could help alleviate some of the symptoms.
Unfortunately, there’s no magic pill that’s going to make your symptoms go away forever.
Treatment will require some trial and error, and potentially a combination of therapies — both medical and psychological.
Because there’s so much to do, it’s best that you get started with solving the problem today.
Whether your anxiety is out of hand or in need of tending, treating it should be a “now” problem as opposed to a “someday” problem.
Delaying treatment is only going to mean a longer wait for results — and results may take time as you work through treatment options to find the right one for you.
While reading is always a good thing, take our advice: do yourself a favor and talk to someone.
Anxiety can feel overwhelming, and some sufferers might be tempted to accept their condition as the status quo. Don’t let that be you. Get the help now that you do deserve for a problem you don’t deserve. If you’re ready, consider scheduling a telepsychiatry evaluation today or checking out our online therapy offering.
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