Understanding Medications for Anxiety: What You Need to Know
Managing anxiety can look different for everyone. For some, therapy tools like breathing exercises, grounding, and cognitive strategies are enough to help regain balance. For others, the symptoms of anxiety can become so strong that additional support through medication becomes an important part of treatment.
Medication for anxiety is not about weakness — it’s about giving your body and mind the support they need so that you can function, heal, and live more fully. Here’s a breakdown of some of the most commonly discussed medication options for anxiety, how they work, and what makes them different.
SSRIs: A Common First Step
SSRIs (Selective Serotonin Reuptake Inhibitors) are one of the most common first-line medications for anxiety and depression.
How they work in the body: SSRIs increase the availability of serotonin in the brain by blocking (or “inhibiting”) the reabsorption of serotonin back into nerve cells. With more serotonin available, brain cells can communicate more effectively, which supports better mood regulation, improved sleep, and reduced anxiety symptoms over time.
Examples of SSRIs:
Sertraline (Zoloft)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Benefits: SSRIs can help reduce persistent worry, intrusive thoughts, and emotional symptoms of anxiety. They are usually taken daily and may take several weeks to show their full effect.
Buspirone: A Different Class of Anxiety Medication
Buspirone (BuSpar) belongs to a different class of medications known as azapirones.
How it works in the body: Unlike SSRIs, Buspirone does not change the amount of serotonin available. Instead, it works directly on serotonin receptors (specifically 5-HT1A receptors), helping regulate how serotonin “signals” in the brain. This leads to reduced anxiety without sedation or dependence.
When it can be helpful:
Buspirone often works well for people whose anxiety shows up strongly in the body — physical tension, restlessness, a racing mind.
Because it is non-sedating, people can take it while continuing to function in daily life, whether at work, school, or caring for family.
Beta Blockers: Managing Physical Symptoms of Anxiety
Beta blockers are medications that were originally developed for heart conditions and high blood pressure, but they are sometimes prescribed for anxiety.
How they work in the body: Beta blockers reduce the effects of adrenaline (the “fight-or-flight” hormone). They block beta receptors in the heart and blood vessels, which slows the heart rate, reduces shaking, and decreases sweating. By calming these physical symptoms, the mind also feels calmer.
When they are used:
Helpful for performance anxiety, such as public speaking, tests, or interviews.
Often taken as needed rather than daily.
Benefits: Beta blockers calm the body’s stress response without sedation, allowing people to remain alert and present.
Sleep Aids and Nighttime Anxiety
For many people, anxiety doesn’t stop when the day ends. Nighttime can be a time when worries feel the loudest. While some medications (like hydroxyzine) can help in the moment, their sedating effect is not always practical. For some, being overly drowsy can even trigger more anxiety.
This is why it is important to explore non-habit-forming options for sleep when anxiety is the underlying cause.
Gabapentin: An Off-Label but Helpful Option
For many people, anxiety doesn’t stop when the day ends. Nighttime can be when worries feel the loudest, making it hard to rest. Medications sometimes prescribed for sleep, like hydroxyzine, may provide relief, but their sedating effects can feel overwhelming for some people or even trigger more anxiety.
This is where Gabapentin can sometimes be a helpful option. Originally developed to treat seizures and nerve pain, Gabapentin is also prescribed off-label for anxiety and sleep difficulties.
How it works in the body: Gabapentin affects neurotransmitters in the brain by calming overactive nerve signals. It doesn’t increase serotonin or dopamine directly, but instead reduces the excitability of neurons. This can ease physical tension, quiet mental restlessness, and support more restorative sleep.
Benefits:
Can help reduce nighttime anxiety.
Supports deeper, more consistent rest.
Non-habit-forming, making it different from many medications sometimes prescribed for sleep.
When anxiety is managed during the day with something like an SSRI or Buspirone, Gabapentin at night can sometimes provide balance by calming the nervous system and supporting recovery through sleep.
The Importance of Options and Advocacy
Every person’s experience with anxiety is unique, which means the right treatment plan will also be unique. Some people benefit from therapy alone, while others need a combination of therapy and medication.
The most important thing to remember is this: you have options.
If one medication doesn’t feel right, there may be another approach.
If sedation feels overwhelming, there are non-sedating choices.
If daytime anxiety is managed but nighttime worry remains strong, there are ways to target that specifically.
You deserve a treatment plan that fits your needs and allows you to live your life fully. Don’t be afraid to ask your doctor questions, share your concerns, and advocate for what feels best for your body and mind.
Important Note
The information shared in this blog is for educational purposes only. It is not a substitute for medical advice, diagnosis, or treatment. I do not prescribe medication. If you are considering medication for anxiety, please consult with a qualified medical provider who can assess your individual needs and guide you in creating a safe and effective treatment plan.
A Gentle Reminder
Medication is just one piece of the puzzle. Skills learned in therapy — such as breathing exercises, grounding practices, and emotion regulation — remain essential. But for some, adding medication allows those tools to work because the nervous system is no longer overwhelmed.
At The Child & Family Therapy Place, Inc., I work with clients to integrate therapeutic tools and, when needed, collaborate with medical providers to ensure you have the right support in place.
✨ If anxiety is interfering with your daily life, call me at 831-272-2041. I provide therapy in English and Spanish for clients in Salinas and throughout California.
👉 Learn more on my Services page.
