There is no best medication for generalized anxiety disorder (GAD). Doctors base treatment plans on factors such as the severity of symptoms and the person’s response to the recommended drugs. However, antidepressants are the first-line medications to treat GAD.
What one person finds effective for GAD may not be the same for another. People usually find the best medication for them through trial and error.
This article provides an overview of GAD. It then lists some of the most commonly used medications, explaining how they work and accompanying side effects.
GAD is a mental health condition. People with GAD experience excessive, persistent, and unrealistic worry about everyday things. People may worry about finances, family, health, or the future.
Symptoms can include:
- restlessness
- fatigue
- difficulty concentrating
- irritability
- muscle tension
- sleep issues
Medication and cognitive behavioral therapy (CBT) are the
There is no one best medication for GAD. What works for one person might not work for another. Often, people find the best medication for them through trial and error.
The first medication doctors will usually recommend for GAD is antidepressants.
Selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI) are both types of antidepressants. They will work in between
They work by increasing the level of serotonin in the brain. Serotonin is a neurotransmitter, which is a chemical that carries messages between brain cells. It plays a role in feelings of well-being and happiness.
Types of antidepressants that a doctor may prescribe include the following:
It can take a
Dose
People will take antidepressants every day. The exact dose will depend on the type of antidepressant the doctor recommends and on the severity of the person’s symptoms.
Sometimes it can be a case of trial and error to find the right dose.
Typical doses can include:
| Antidepressant | Dose |
|---|---|
| escitalopram | A doctor may prescribe 10–20 mg once a day, with or without food. |
| duloxetine | A doctor may prescribe 20–120 mg once or twice a day with or without food. |
| venlafaxine | A doctor may prescribe 37.5–300 mg, 2–3 times a day with or without food. |
| paroxetine | A doctor may prescribe 10–40 mg once a day, with or without food. |
Side effects
According to the United Kingdom’s National Health Service (NHS), antidepressants can cause the following side effects:
- agitation
- anxiety
- nausea and vomiting
- indigestion
- constipation or diarrhea
- appetite loss
- dizziness
- insomnia
- headaches
- loss of libido
- difficulties achieving orgasm
- difficulties achieving and maintaining erections
Learn more about the sexual side effects of antidepressants.
People should not stop taking their medication without speaking with a doctor first to avoid withdrawal symptoms.
What should a person avoid when taking this medication?
A person should not take SSRIs and SNRIs alongside:
- other SSRIs
- MAOIs
- tricyclic antidepressants
- psychotropic medications
- triptans
- some antibiotics, including linezolid
- amphetamines
Additionally, some antidepressants can increase the effects of other medications. These include:
A doctor may prescribe a benzodiazepine when a person requires immediate relief from the symptoms of anxiety. Mental Health America notes that they usually start working within 30 minutes to an hour and wear off within a few hours.
A person will usually only take these medications for a short time as there is a risk of dependency.
Benzodiazepines strengthen a calming neurotransmitter called gamma-aminobutyric acid (GABA).
Two types of benzodiazepines include diazepam and clonazepam.
Dose
The National Alliance on Mental Illness notes that people can take diazepam and clonazepam at regular times, or when a person requires them.
A person should speak with a doctor about how many doses they can take in a single day.
Side effects
Common side effects of benzodiazepines include:
- dizziness
- drowsiness
- fatigue
- lightheadedness
- a decreased ability to concentrate
- impaired coordination
In rare cases, a person may experience:
- shortness of breath
- increased heart rate
- headaches
- irritability
- memory impairment
- restlessness
What should a person avoid when taking this medication?
People should avoid drinking alcohol if they are taking benzodiazepines.
There are also some medications that people should avoid when taking benzodiazepines. However, which medications a person should avoid depends on the benzodiazepine they are taking.
People should speak with a doctor to find out which medications they should avoid.
Anxiolytic drugs, such as buspirone, are another treatment option for GAD. As with antidepressants, anxiolytic drugs strengthen the effects of serotonin in the brain.
People will take the medication every day, but it can take
Dose
People usually take drugs such as buspirone twice per day, with or without food.
The exact dose will depend on how the person responds to the drug. Sometimes it can be a case of trial and error to find the right dose.
Side effects
Long-term use of buspirone is safe, providing a person takes the medications as a doctor instructs. However, side effects can occur.
These can include:
- nausea
- headaches
- changes in dreams
- dizziness
- drowsiness
- lightheadedness
What should a person avoid when taking this medication?
Anyone taking buspirone should avoid doing so alongside alcohol or illegal drugs. These can decrease the benefits of the medication and increase the risk of adverse effects.
A person may experience a severe increase in blood pressure if they take buspirone alongside the following medications within 2 weeks:
- monoamine oxidase inhibitors (MAOIs)
- selegiline
- tranylcypromine
People should also avoid taking buspirone alongside the following medications:
- diltiazem
- verapamil
- rifampin
Drinking large amounts of grapefruit juice can increase the levels of buspirone in the blood.
According to a
The United States Food and Drug Administration (FDA) has placed boxed warnings on benzodiazepines and antidepressants.
The FDA warns that benzodiazepines can result in slowed breathing or death when taken with other opioid medications. In addition, there is a risk of a person becoming dependent on these medications. A person may also experience withdrawal symptoms.
They also warn that antidepressants can lead to suicidal thoughts or actions in children and adults
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Mental health medication can be expensive. For some people, health insurance will cover medications for GAD. People should check their insurance policy to determine what they are entitled to.
Medicaid may be able to help some people.
People may also benefit from the following organizations:
Doctors will
The Anxiety and Depression Association of America also suggests people take regular exercise. It can help to reduce stress and anxiety.
Doctors will usually prescribe antidepressants to treat GAD. These can include escitalopram, duloxetine, venlafaxine, and paroxetine. It is important to note that the FDA has placed a boxed warning on these medications as they can lead to suicidal thoughts and tendencies in those under the age of 25.
For short-term relief of anxiety symptoms, a doctor may prescribe benzodiazepines. These are fast-acting medications that a person should avoid taking for long periods of time.
Benzodiazepines also include a boxed warning. People should avoid taking benzodiazepines for long periods as there is a risk of dependency and severe adverse effects.
Buspirone is a nonbenzodiazepine medication that does not lead to dependency. There is no boxed warning for this medication.
People should speak with a doctor about the correct doses and other medications they should avoid while taking the medication.