Talk to a provider about the right anxiety medication and treatment for you.
Anxiety
19 min read
Written by Megan Moore
Published: Jul 22, 2024
Medically Reviewed by Dr. Paul Hetrick
If you live with anxiety, you’re likely familiar with how it touches nearly every part of your daily life, with overwhelming symptoms like panic attacks, a racing heart, trembling, and sweating. Finding effective treatment is key, and it often involves medication. But, if you’ve struggled with substance use in the past, you might wonder, are there non-addictive anxiety medications?
While some anxiety meds can be habit-forming, there are, fortunately, plenty of effective, non-habit-forming anxiety medications available. We cover the 8 best ones here.
If you’re struggling with anxiety and interested in medication, a mental health specialist on Klarity can diagnose and prescribe anxiety medication online. Find a provider on Klarity Health today to get anxiety treatment on your terms.
Before digging into available non-addictive anxiety medications, it’s important to learn how they differ from habit-forming, or addictive, anxiety medications.
Habit-forming anxiety medications have the potential to be addictive. That’s because, while they’re effective at managing anxiety symptoms, many are only meant for short-term use. The longer they’re used, the less effective they become as your body builds up tolerance. This increases the likelihood of addiction or abuse.
The most common class of addictive anxiety medications is benzodiazepines, like Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam). These medications boost the effect of the neurotransmitter GABA (gamma-aminobutyric acid), which is responsible for reducing brain excitability, in other words lowering brain activity to prevent overstimulation. As a result, benzodiazepines and other addictive anxiety meds promote relaxation and reduce anxiety symptoms.
Alternatively, non-addictive anxiety medications are generally approved for long-term use. And, providers often choose to try them before addictive options. Many non-addictive anxiety medications work by preventing the brain’s nerve cells from reabsorbing serotonin and/or norepinephrine. Both of which affect mood and stress.
Some of these medications are U.S. Food and Drug Administration (FDA)-approved to treat other health conditions. They include antidepressants, allergy medications, and blood pressure medications. Sometimes the FDA has approved them to help manage anxiety symptoms. Otherwise, they’re prescribed off-label (for something they’re not FDA-approved for) for anxiety.
Many non-addictive anxiety medications are available. Here are 8 options.
Selective serotonin reuptake inhibitors (SSRIs) increase the brain’s serotonin levels. This brain chemical plays a key role in mood and sleep, so increasing its availability improves your mood and reduces anxiety symptoms.
They take a few weeks before you feel their full effects. So they aren’t always a good option if you need immediate relief.
There is the potential for side effects with SSRIs, such as headaches, insomnia, and blurred vision. They can also cause withdrawal symptoms (like nausea, vertigo, chills, and visual disturbances) if they’re stopped suddenly.
SSRIs FDA-approved to treat anxiety include Lexapro (escitalopram) and Paxil (paroxetine). SSRIs prescribed off-label for anxiety include Prozac (fluoxetine), Zoloft (sertraline), and Celexa (citalopram).
Serotonin norepinephrine reuptake inhibitors (SNRIs) are similar to SSRIs. The biggest difference when comparing SSRIs vs SNRIs is that SNRIs increase levels of norepinephrine as well as serotonin. Norepinephrine is critical for alertness, attention, and arousal. Increasing both serotonin and norepinephrine in the brain can decrease anxiety, boost mood, and even help with chronic pain related to anxiety.
SNRIs can cause side effects like nausea, dry mouth, or constipation. People sometimes notice heightened anxiety symptoms in the first few weeks of taking them. Like SSRIs, SNRIs can cause withdrawal symptoms if you suddenly stop taking them. Some users report that SNRI withdrawal tends to be worse than SSRI withdrawal.
Common SNRIs for anxiety include Cymbalta (duloxetine) and Effexor (venlafaxine). Pristiq (desvenlafaxine) can also be used to treat anxiety off-label. Learn more about Cymbalta vs Pristiq, Effexor vs Pristiq, and Cymbalta vs Effexor.
Beta-blockers are primarily prescribed for high blood pressure and abnormal heart rhythms. They aren’t approved to treat anxiety, but they can be used off-label for it. They work by blocking the receptors that receive and respond to adrenaline and noradrenaline, brain chemicals that trigger your fight-or-flight response.
When the effects of adrenaline on the body are reduced by beta-blockers, you experience fewer anxiety symptoms. This includes a decrease in things like fast heartbeat, sweating, and trembling. Beta-blockers may also promote calmness by preventing physical symptoms from increasing your anxiety.
Beta-blockers don’t help balance the neurotransmitters of the brain; only the effects of adrenaline and noradrenaline on the beta receptors in the heart and blood vessels. This makes them ineffective for long-term anxiety management or for preventing anxiety symptoms. Instead, they’re primarily used for immediate anxiety relief.
Beta-blockers commonly prescribed off-label for anxiety are Sectral (acebutol), Tenormin (atenolol), Inderal (propranolol), and Zebeta (bisoprolol). Learn more about Inderal vs Zebeta.
Tricyclic antidepressants (TCAs) were 1 of the earliest antidepressants developed. While not FDA-approved for anxiety, they can be an effective off-label anxiety treatment. They work similarly to SNRIs — by increasing the levels of serotonin and norepinephrine in the brain. But, they can also affect other brain chemicals, making SNRIs or SSRIs more preferable.
TCA side effects include drowsiness, blurred vision, and increased or irregular heart rate. They also have a risk for toxicity and withdrawal symptoms. Generally, TCAs are prescribed for more debilitating anxiety, and providers tend to recommend other medications before TCAs.
Some TCAs that can be used off-label to manage anxiety include Vivactil (protriptyline), Elavil (amitriptyline), Asendin (amoxapine), and Surmontil (trimipramine). Learn more about amoxapine vs trimipramine, tricyclics vs SNRIs, and tricyclics vs beta-blockers for anxiety.
Buspirone is in a class of medications called anxiolytics that help decrease anxiety symptoms by changing the amounts of neurotransmitters in the brain. It works on only 1 type of serotonin receptor in the brain, which means it may cause fewer side effects.
Some medications in the anxiolytic class are habit-forming, but buspirone is considered non-addictive. It’s FDA-approved for the treatment of chronic anxiety or panic. It can take a few weeks to reach its full effect.
Buspirone’s side effects include dizziness, nausea, headaches, and difficulty sleeping. But, it doesn’t cause sedation or drowsy feelings like other non-addictive anxiety medications can.
Buspirone is often prescribed under the brand names Buspar or Vanspar.
Antihistamines are generally used to treat allergies. They work by blocking the effects of histamine, which normally triggers allergic and anaphylactic symptoms, such as accelerated heart rate, upset stomach, and flushing in response to an allergen. Researchers aren’t sure exactly how antihistamines work for anxiety, though. It likely has to do with their ability to affect histamine and serotonin levels, which can promote feelings of calmness. Drowsiness is the most common side effect.
Vistaril (hydroxyzine) is 1 antihistamine that’s fast-acting and effective at temporarily managing anxiety symptoms. Similarly, Benadryl (diphenhydramine) may help manage anxiety symptoms due to its sedative effects, but it’s not FDA-approved to treat anxiety. People who use it off-label report that it does offer relief during anxiety attacks but note that it causes sedation.
Gabapentin is an anticonvulsant primarily used to treat seizures. But it’s also used off-label to reduce anxiety symptoms. It enhances the activity of GABA, a neurotransmitter responsible for calming your nervous system. The overall effect promotes a calming sensation that improves anxiety symptoms.
Gabapentin’s side effects can include nausea, vomiting, and blurred vision. Still, it’s a long-term anxiety medication that starts working quickly — sometimes in as little as a week.
Some states classify gabapentin as a Schedule V Controlled Substance. The Federal Controlled Substance Act doesn’t. A Schedule V Controlled Substance has some risk for addiction though the risk is lower than higher-level controlled substances. (There are 5 levels of controlled substances, I, II, III, IV, and V. Schedule I Controlled Substances are the riskiest and labeled and illicit drugs.)
Gabapentin for anxiety is a generic drug. Brand names of gabapentin include Horizant, Gralise, and Neurontin.
Pregabalin is an anxiolytic medication, like buspirone. It’s commonly used to treat epilepsy, nerve pain, and anxiety. It works by decreasing certain brain chemicals that stimulate the nervous system, including norepinephrine. It also reduces nerve overactivity and is thought to enhance the effects of GABA, much like Gabapentin.
Common side effects include drowsiness, headache, and dizziness. Pregabalin often works faster than SSRIs and SNRIs, making it an option for people who need immediate relief.
Pregabalin is a Schedule V controlled substance at the Federal level. Like, gabapentin, it does have a low potential for addiction and misuse.
Pregabalin is a generic and is also available as brand name Lyrica.
Provider opinions and patient reviews of the best non-addictive anxiety medications are informative, especially if you’re considering taking 1. We’ve combed online reviews to provide you with a look at what real people with anxiety have to say.
According to Scott D. Mendelson, a retired psychologist and neuroscientist, via Quora, hydroxyzine and propranolol (a beta-blocker) can be taken for anxiety, as needed or daily, and are non-addictive. But, neither drug is considered very effective for severe anxiety, especially compared to benzodiazepines.
Alan Koenigsberg, MD states, “For chronic moderate-to-severe anxiety disorders, the SSRI and SNRI medications, that are typically considered antidepressants, are effective for many people.” He notes that it can take several weeks to months for these meds to achieve full therapeutic benefits.
On his YouTube channel, Erik Richardson, DO, says he commonly prescribes propranolol for situational anxiety or as a daily medication for milder anxiety. It helps slow heart rate and triggers a calming response. He also states that hydroxyzine can be quite effective for those who experience anxiety at night and have trouble sleeping as a result. But, because it causes sleepiness, it isn’t great for daily use. When it comes to the prevention of anxiety symptoms, Dr. Richardson claims antidepressants are most commonly prescribed, such as SSRIs and SNRIs. The most effective, in his opinion, are escitalopram (Lexapro), sertraline (Zoloft), citalopram (Celexa), and paroxetine (Paxil).
Patient perspectives on non-addictive anxiety medications are mixed. Reviews from Reddit users include positive comments about propranolol and Buspar (buspirone) when it comes to managing generalized anxiety and panic attacks. Others benefit from hydroxyzine but dislike the sleepiness they feel while taking it.
On WebMD, patients report satisfaction with Buspar for anxiety and panic attacks. Even despite some side effects. CC, a 19- to 24-year-old female, states, “What a difference it has made. I will say, when I increased my dosage, I experienced some ‘interesting side effects.’ It was so hard for me to regulate my mood. However, that settled after a couple of weeks.”
Jason, a 35- to 44-year-old male, writes, “[Buspar] let me experience life calmly for the first time. No side effects. It’s a miracle.”
SSRIs also have mixed reviews on WebMD. Prozac is rated 3.7 out of 5 at the time of publication. Some users, like Lstephens, found it very helpful for managing intense anxiety symptoms but had to adjust the dose during times of extreme life stress. Others noted side effects like increased anxiety, paranoia, and fear that tended to resolve the longer they were on Prozac.
The right non-addictive anxiety medication varies from person to person. Talk to your healthcare provider about which anxiety medication, if any, is right for you.
On Klarity Health, find a mental health provider for a comprehensive evaluation and anxiety treatment plan. If anxiety medication is right for you, your provider can give you a prescription. Make your way to better mental health when you find a provider on Klarity Health today.
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Quora, Are There Any Non-Addictive Anti-Anxiety Medications, https://www.quora.com/Are-there-any-non-addictive-anti-anxiety-medications
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WebMD, User Reviews for Buspirone Oral, Jul 2024, https://reviews.webmd.com/drugs/drugreview-8876-buspirone-oral
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YouTube, Top Medications for Treating Anxiety, Erik Richardson D.O., Dec 2020 https://www.youtube.com/watch?v=fsky5WShpN8
The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with full medical authority. No diagnosis result or treatment option is guaranteed for the services rendered through the Klarity Health platform.
If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.
How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.
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