Mental health

Medicines for Anxiety disorders

Persistent, excessive worry and physical tension that interfere with daily life — treated mainly with talking therapies and, where needed, well-established medicines.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review

Quick answer

What is Anxiety disorders?

Anxiety becomes a disorder when worry is excessive, hard to control and out of proportion to the situation, and when it keeps going for weeks or months and interferes with everyday life. Generalised anxiety disorder (GAD) is the most common form: a free-floating, persistent sense of dread that is not tied to one particular thing, often with physical symptoms such as a racing heart, muscle tension, restlessness, poor sleep, tiredness and difficulty concentrating.

  • How it is treated: Treatment is matched to severity and to the person's preferences, and usually follows a stepped approach.
  • Self-care: Regular physical activity, a steady sleep routine, cutting back on caffeine and alcohol, breathing and relaxation techniques, and reducing avoidance of feared situations all help to ease anxiety and support recovery alongside therapy and any medication.
  • When to seek help: Seek prompt help if anxiety is severe, stops you coping with everyday life, or comes with panic attacks you cannot manage.

What it is

Anxiety becomes a disorder when worry is excessive, hard to control and out of proportion to the situation, and when it keeps going for weeks or months and interferes with everyday life. Generalised anxiety disorder (GAD) is the most common form: a free-floating, persistent sense of dread that is not tied to one particular thing, often with physical symptoms such as a racing heart, muscle tension, restlessness, poor sleep, tiredness and difficulty concentrating. Related conditions include panic disorder, social anxiety and phobias. Anxiety is common, treatable and not a personal failing; it frequently overlaps with low mood, and a careful assessment looks at how severe it is, how much it affects function, and whether depression is also present.

How it is treated

Treatment is matched to severity and to the person's preferences, and usually follows a stepped approach. For milder anxiety, education, self-help and guided support often come first. Psychological therapy — particularly cognitive behavioural therapy (CBT) — is central and is frequently the first-line treatment; it helps people understand and gradually change the thinking patterns and avoidance that keep anxiety going. Medicine is offered when symptoms are more troublesome, when therapy has not been enough, or alongside therapy by choice. Antidepressants are the mainstay of drug treatment for ongoing anxiety; they take a few weeks to begin working and are reviewed regularly and reduced gradually rather than stopped abruptly. Brief questionnaires are commonly used to gauge severity and track response over time.

For this condition, these medicines

Medicine classes used for Anxiety disorders

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

SSRIs Mental health Usually the first-line drug treatment for ongoing anxiety; generally well tolerated. SNRIs Mental health An alternative or next step when an SSRI has not helped or is not suitable. Gabapentinoids Neurology Pregabalin is licensed for generalised anxiety disorder and used as a further option. Benzodiazepines and Z-drugs Mental health Only for short-term or crisis use because of the risk of dependence; not for long-term anxiety. Beta-blockers Cardiovascular Can ease physical symptoms such as palpitations and tremor, particularly in performance situations.

Symptom checker

Symptoms that can point to Anxiety disorders

Anxiety disorders can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:

Chest painDiscomfort, pressure, tightness or sharp pain anywhere in the chest that can come from the…Shortness of breathA feeling of not being able to get enough air, breathing faster or harder than normal, or …DizzinessA broad term covering a spinning sensation (vertigo), feeling faint or lightheaded, or fee…Night sweatsSweating heavily during sleep, often enough to soak your nightclothes or bedding.…Feeling faintFeeling light-headed and as though you might pass out, or briefly losing consciousness.…PalpitationsAn unusual awareness of your own heartbeat — feeling it race, pound, flutter or skip — whi…Hot flushesSudden waves of heat, flushing and sweating, often spreading over the face, neck and chest…Low moodLow mood means feeling sad, flat or down for a period of time, which can be a normal react…Memory problemsMemory problems mean finding it harder to remember things or think clearly, which can have…TremorA tremor is a rhythmic shaking or trembling, most often of the hands, which can have many …Excessive sweatingExcessive sweating means sweating more than the body needs to cool itself, which can affec…Excessive daytime sleepinessA persistent struggle to stay awake during the day — nodding off, fighting heavy eyelids o…Dry mouthA persistent feeling that the mouth is dry and short of saliva — often a side effect of me…Feeling of a lump in the throatA persistent sensation of something stuck in the throat when nothing is actually there — u…Excessive hungerA persistent or unusually strong urge to eat that is out of keeping with your normal appet…Difficulty concentrating / brain fogA frustrating sense of being mentally cloudy, forgetful or unable to focus, most often cau…Cold sweatsBreaking out in a clammy, cold sweat that is not caused by heat or exertion — often a norm…Mood swingsMarked ups and downs in mood that can be a normal response to stress, sleep loss or hormon…Unwanted intrusive thoughtsUnwanted, distressing thoughts, images or urges that pop into the mind against your wishes…Binge eating and loss of control with foodRecurring episodes of eating a large amount of food with a sense of being unable to stop, …

Clinical formulas & tools

Calculators used in Anxiety disorders

Risk scores and formulas that inform assessment and treatment decisions in this condition:

GAD-7 (Anxiety)Severity of generalised anxiety symptoms.GAD-2 (Anxiety Screen)Two-item anxiety screen.

By active ingredient

Specific medicines used for Anxiety disorders

Dose-free guides to individual active ingredients used in anxiety disorders — what each is, how it works, how to take it, and its advantages and disadvantages:

PropranololA non-selective beta-blocker with broad uses — blood pressure, migraine prevention and the…SertralineA commonly first-chosen SSRI antidepressant for depression and anxiety, taken once a day.…CitalopramA commonly used SSRI antidepressant for depression and anxiety, taken once daily as a long…FluoxetineA long-acting SSRI antidepressant for depression and anxiety, and the SSRI most used in yo…PregabalinA gabapentinoid for nerve pain, epilepsy and generalised anxiety that settles over-active …VenlafaxineAn SNRI antidepressant for depression and anxiety that lifts mood by boosting two brain ch…DuloxetineAn SNRI used for depression and anxiety, and also widely used for nerve pain such as diabe…EscitalopramA widely used SSRI for depression and anxiety, closely related to citalopram and generally…ParoxetineAn SSRI for depression and anxiety, effective but known for more troublesome discontinuati…HydroxyzineA sedating antihistamine used to relieve itching and hives, and for short-term help with a…DiazepamA long-acting benzodiazepine used short-term for severe anxiety, certain muscle spasms and…LorazepamA benzodiazepine used for short-term relief of severe anxiety and a number of other situat…OxazepamA short-acting benzodiazepine used only for the short-term relief of severe anxiety, effec…BuspironeAn anti-anxiety medicine that eases generalised anxiety over time, without the dependence …PericiazineAn older phenothiazine antipsychotic, also used for severe anxiety or agitation, that is m…AlprazolamA short-acting benzodiazepine sometimes used for anxiety or panic, but not a first-line UK…

Beyond medication

Lifestyle and self-care

Regular physical activity, a steady sleep routine, cutting back on caffeine and alcohol, breathing and relaxation techniques, and reducing avoidance of feared situations all help to ease anxiety and support recovery alongside therapy and any medication.

When to get help

When to see a doctor

Seek prompt help if anxiety is severe, stops you coping with everyday life, or comes with panic attacks you cannot manage. If you have thoughts of harming yourself or that life is not worth living, get help now — contact your GP urgently, call 111, go to A&E, or call the Samaritans on 116 123.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Anxiety disorders: frequently asked questions

What medicines are used for anxiety?

For ongoing anxiety, SSRIs are usually first-line, with SNRIs as an alternative and pregabalin (a gabapentinoid) as a further option. Beta-blockers can help physical symptoms such as palpitations. Benzodiazepines may be used only for the short term in a crisis, because of the risk of dependence. Talking therapy such as CBT is also a core treatment in its own right.

Do I have to take medication, or is therapy enough?

For many people, a talking therapy such as CBT is effective on its own and is often the first-line treatment. Medicine is offered when symptoms are more troublesome, when therapy has not been enough, or alongside therapy by choice — the right approach depends on severity and your preferences.

How long do anxiety medicines take to work?

Antidepressants used for anxiety typically take a few weeks to begin helping, and the full benefit can take longer. It is important not to stop early just because you feel no immediate change, and to review with your prescriber if there is no improvement after a few weeks.

Why are sedatives not used long term for anxiety?

Benzodiazepines and similar sedatives can ease symptoms quickly, but the body becomes used to them and they carry a real risk of dependence and withdrawal. For these reasons they are reserved for short-term or crisis use, while antidepressants and therapy are used for ongoing anxiety.

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Sources

Where this is drawn from

  • NICE CG113: Generalised anxiety disorder and panic disorder in adults: management.
  • NICE CKS: Generalised anxiety disorder in adults.

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