Anxiety and depression: Which medications are best? 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The most suitable drug will depend on a variety of factors, such as the severity of the anxiety or depression. According to the World Health Organization (WHO), approximately 5% of adults globally experience depression. Anxiety disorders are the most common type of mental health condition in the United States, affecting 40 million adults yearly. This article will discuss medications a doctor may prescribe to treat anxiety and depression. It will also explore other treatment options and diagnostic processes for these conditions. What are anxiety and depression Share on PinterestMarc Tran/StocksyAnxiety and depression are mental health conditions. They often co-occur, with around 45% of people worldwide with lifetime major depressive disorder also experiencing one or more anxiety disorders. Anxiety Anxiety links closely with fear. This results in a future-oriented mood and behavioral response, where the person prepares for an anticipated event or situation that they perceive as threatening. The fear can become worse over time and may interfere with daily life. Different types of anxiety disorders include generalized anxiety disorder, panic disorder, and phobias. Depression Depression is a mood disorder. It may result in symptoms such as:persistent sadnesshopelessnessirritabilitydifficulty sleeping and concentratingthoughts of suicide Like anxiety, depression may interfere with a person’s daily life. Learn more about common signs and symptoms of depression. Best medications for anxiety and depression Doctors may recommend medication in combination with other treatment options such as therapy for people experiencing anxiety and depression. The most suitable treatment will depend on a person’s symptoms, co-occurring conditions, and the severity of their condition. Some medications can treat both conditions, while others are more suited to treating either anxiety or depression. Antidepressant medications can help improve the symptoms of depression. With adequate treatment, 70–80% of people with depression may experience a significant reduction in their symptoms. Medication for anxiety does not cure the condition but may help with symptoms, such as panic attacks, extreme fear, and worry. Selective serotonin reuptake inhibitors Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that doctors consider first-line treatments for depression and anxiety. SSRIs work by increasing the level of serotonin in the brain. Serotonin is a molecule that has important bodily roles, including regulating mood and behavior. Researchers believe that decreased serotonin in the brain may result in mental health conditions such as depression and anxiety. By increasing serotonin levels, SSRIs may help improve the symptoms of these conditions. However, it may take up to 6 weeks before a person feels the beneficial effects of SSRIs. Examples of SSRIs that doctors prescribe in the U.S. include:fluoxetinesertralineparoxetinefluvoxaminecitalopramescitalopramvilazodone Side effects Side effects of SSRIs include:anxietyrestlessnessinsomniadry mouthweight gainnauseadiarrheasweatingheadachesdizzinessdecreased sex driveanorgasmia, or difficulty orgasming There is also an increased risk of suicidal ideation with SSRIs in young people up to age 25. Some SSRIs such as citalopram can affect the heart, potentially leading to abnormal heart rhythms. Dosage A person takes SSRIs orally. They are available as tablets, capsules, liquid suspensions, and solutions. The starting dose varies with each drug. For example, the starting dose for citalopram is 20 milligrams (mg) daily, while it is 5–10 mg per day for escitalopram. A doctor may increase or decrease a person’s dose depending on the severity of their anxiety and how well they respond to treatment. Stopping medication A person may wish to discontinue SSRI treatment for various reasons, including side effects. A doctor will likely recommend that a person gradually lower their dosage over weeks or months. A person may experience discontinuation symptoms when coming off SSRIs, including low mood and irritability. Learn more about antidepressant withdrawal. Serotonin-noradrenaline reuptake inhibitors Serotonin-noradrenaline reuptake inhibitors (SNRIs) are another class of drugs that doctors consider first-line treatment for anxiety and depression. SNRIs block the reuptake of serotonin and another chemical known as noradrenaline or norepinephrine, increasing the levels of these chemicals in the brain. In this way, they can have a beneficial effect on mood and emotion. SNRIs may take between 6–8 weeks to have a noticeable effect. Examples of SNRIs include:venlafaxinedesvenlafaxineduloxetinemilnacipranlevomilnacipran Side effects Common side effects of SNRIs include:nauseainsomniadry mouthincreased blood pressuresexual dysfunctionweight gainheadaches There is also an association between this kind of medication and an increased risk of reduced bone mineral density and falls. In the elderly, this may result in fractures. Dosage The starting dose for SNRIs may also vary depending on the drug. For example, the starting dose for milnacipran is 12.5 mg per day, while the starting dose for venlafaxine is 37.5 to 75 mg per day. Learn more about SSRIs and SNRIs. Benzodiazepines Benzodiazepines are a type of antianxiety medication that may help reduce anxiety symptoms. They work by enhancing the activity of gamma-aminobutyric acid, a chemical in the brain that has a repressive effect on nerves and movement. According to research, the effects of benzodiazepines occur within 30–60 minutes. These fast-acting drugs may help with anxiety symptoms such as panic attacks, insomnia, and muscle tension. Examples of benzodiazepines include:alprazolam (Xanax)clonazepamdiazepamlorazepam Side effects The drawback of benzodiazepines is that a person may develop tolerance to the medication. This means they require a higher dose to have the same effect. Because of this, a person may become dependent, and doctors usually prescribe benzodiazepines for short-term use only. Learn more about drug dependence. A person using benzodiazepines may experience some side effects, such as:drowsinessdizzinesssedationloss of balance Learn more about withdrawing from benzodiazepines. Risks There is also an association between benzodiazepine use and an increased risk of being unable to learn or remember new information or do certain physical and cognitive tasks. These side effects normally reduce once the drug clears the body. Other risks associated with long-term benzodiazepine use include:dementia or dementia-like illnessesimpaired motor functionaggressive behaviorimpaired cognitive functionaddiction Tricyclic antidepressants Tricyclic antidepressants (TCAs) are a class of medications doctors use to treat depression. Some may also prescribe them for anxiety. TCAs work by blocking the reuptake of serotonin and noradrenaline, increasing their levels in the brain. Examples of TCAs include:amitriptylineimipraminenortriptyline Side effects Side effects of TCAs include:dry mouthurinary retentionconstipationseizureslow blood pressure As they can cause significant adverse effects, doctors do not often prescribe TCAs for anxiety. Learn more about TCAs. Beta-blockers A doctor may prescribe beta-blockers to help with symptoms of anxiety. Beta-blockers are a class of drugs doctors usually use to treat heart conditions. They inhibit the actions of adrenaline and noradrenaline, hormones that play a role in the body’s fight or flight response. Beta-blockers may be able to improve physical symptoms of anxiety, including:a fast heart ratea trembling voicedizzinesssweatingshaking hands Propranolol and atenolol are examples of beta-blockers a doctor may prescribe for anxiety. Monoamine oxidase inhibitors Monoamine oxidase inhibitors (MAOIs) are a type of antidepressant that blocks the function of monoamine oxidase. Monoamine oxidase is an enzyme that breaks down chemicals such as serotonin, noradrenaline, and dopamine. When a person takes MAOIs, the levels of these chemicals in the brain increase, with a therapeutic effect. MAOIs normally take 2–3 weeks to work. However, doctors do not consider them first-line due to their adverse effects and interactions with other drugs. Examples of MAOIs include:selegilinemoclobemideisocarboxazidphenelzine Side effects Adverse effects of MAOIs may include:dry mouthnauseadiarrheaconstipationdrowsinessinsomniadizziness Other treatment options Medication may not suit everyone, and a person may prefer other treatment options for depression and anxiety. They may wish to consider:Cognitive behavioral therapy (CBT): This focuses on identifying and modifying behaviors that are not constructive in dealing with anxiety and depression. It may provide individuals with skills and tools to react more productively to certain situations.Exposure therapy: This type of therapy involves a person moving toward anxiety-causing situations that they normally avoid to learn how to deal with anxiety and reduce their symptoms.Arts and creative therapy: This involves using music, painting, or drama to help a person express their feelings and deal with symptoms.Talk therapy: This involves a person speaking to a professional about experiences and feelings and may help them find new methods to deal with situations.Support groups: These provide a setting for individuals to meet others with anxiety or depression, with whom they can discuss their feelings.Stress management techniques: Techniques such as exercise, mindfulness, and meditation may help reduce anxiety and depression symptoms. Diagnosis A person will need to see a doctor to receive a diagnosis of anxiety, depression, or both. A doctor will usually take a medical history from the individual. Depending on the symptoms the person is experiencing, the doctor may also conduct a physical exam to rule out other conditions. The doctor will likely ask about symptoms and the person’s mood and emotions. They may ask the person to complete a questionnaire identifying signs and symptoms of anxiety or depression. For a person to receive a diagnosis of depression, their symptoms must be present for at least 2 weeks. When to speak with a doctor A person should speak with a doctor if they have been experiencing symptoms of depression or anxiety, such as low mood or anxious thoughts, for more than 2 weeks. They may also want to see their doctor if they are on antidepressant or antianxiety medication and have been experiencing adverse effects. Summary Anxiety and depression are mental health conditions that affect mood and emotion. Anxiety is linked to fear and depression to low mood. Some medications, such as SSRIs, SNRIs, and TCAs, treat both conditions. Others target one specific condition. Nonmedicinal treatment options for anxiety and depression include CBT, exposure therapy, counseling, and support groups. People should speak with their doctor if they are experiencing symptoms of depression and anxiety. A doctor can advise them on suitable treatment options. Last medically reviewed on August 16, 2022DepressionMental HealthAnxiety / StressPsychology / PsychiatryDrugs 24 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. 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Serotonin reuptake inhibitors and bone health: A review of clinical studies and plausible mechanisms.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372777/FEEDBACK:Medically reviewed by Yalda Safai, MD, MPH — By Sasha Santhakumar on August 16, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageSupport groups for depressionMedically reviewed by Joslyn Jelinek, LCSW Depression support groups can be a source of empathy, companionship, and helpful tips. Here is a list of online and in-person groups.READ MORETreatments for anxiety Anxiety disorders involve a disproportionate reaction to stressful or even neutral life events. 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