Which is the best medication for anxiety?

Written by Shivam Patel, PharmD, BSPS, RPh | Posted November 12, 2018 | Updated December 03, 2020

At some point in our lives, we may develop feelings of anxiety that usually subside without the need for medication. However, a diagnosed anxiety disorder may call for therapy with a licensed professional and/or medication (i.e. psychotherapy and/or pharmacotherapy). Anxiety medications can help people manage their symptoms, allowing their overall quality of life to improve and help them feel better throughout the day. If you feel like you may be experiencing anxiety, don't hesitate to talk to your provider about your options.

How to Determine Which Anxiety Medication is Right for You

Your doctor or provider will determine if you need anxiety medicine and, if so, which one is best for you. There are many different types of anxiety drugs out there. Below is a chart with some helpful information to understand what these anxiety drugs are and how they work. Scroll further down to learn how to best afford these medications.

  Comparing Anxiety Medications
Drug Class Generic Name How It Works Benefits Possible Side Effects
Serotonin norepinephrine reuptake inhibitors (SNRI) Venlafaxine Duloxetine Desvenlafaxine Helps regulate the concentration of serotonin and norepinephrine chemicals in the brain shown to be linked to anxiety disorders. - Effective for many people - 2 to 8 weeks until improvement may be felt Nausea Weight gain Blood pressure changes
Selective serotonin reuptake inhibitors (SSRI) Citalopram Escitalopram Fluvoxamine Paroxetine Fluoxetine Sertraline Helps regulate the concentration of serotonin, a chemical in the brain shown to be linked to anxiety disorders. - Effective for many people - 2 to 6 weeks until improvement may be felt Nausea Nervousness Sexual difficulties
Benzodiazepines Diazepam Alprazolam Lorazepam Clonazepam Research shown to enhance the activity of gamma aminobutyric acid (GABA) in the brain resulting in sedative and relaxed feelings - Many people start feeling better in the first week and some even feel the effects on the first day of treatment. Habit forming Drowsiness Withdrawal symptoms may occur when stopped
Azapirones Buspirone Enhances the activity of serotonin in the brain shown to be linked to anxiety disorders. - Effective for many people - Less sedative than benzodiazepines Works slowly Can't switch from benzodiazepines immediately, must be tapered down first.

Per the Anxiety and Depression Association of America, 1st line FDA approved pharmacotherapy treatments include the following:

SNRI/SSRI
Venlafaxine XR 75 — 225 mg daily 
Duloxetine 60 mg daily (max dose 120 mg/day; age: 7-17 30-60 mg daily, max 120 mg/daily)
Paroxetine 20 mg every morning (max dose 50 mg/day, max elderly dose 40mg/day)
Escitalopram 10 mg daily (max dose 20 mg/day, max elderly dose 10 mg/day)

Per the Anxiety and Depression Association of America, 2nd line FDA approved pharmacotherapy treatments include the following:

Benzodiazepines
Diazepam 2- 10 mg twice daily — four times daily 
Alprazolam 0.25 - 0.5 mg three times daily (max dose: 4 mg/day; elderly start 0.25                                            twice daily — three times daily)
Lorazepam 2 - 6 mg divided two times daily — three times daily (max dose: 10 mg/day; elderly start at 1-2 mg twice daily — three times daily)
Clonazepam 0.25 - 0.5 mg twice daily — three times daily, (max dose: 4 mg/day)
   
Azapirones
Buspirone 30 mg divided twice daily — three times daily, (max dose: 60 mg/day; age: 6-17 15-60mg divided twice daily)
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Anxiety Medication Brand Name Savings Online

Brand-name anxiety medications may be available at much lower cost outside the U.S. and can be purchased from verified international online pharmacies. You can find Cymbalta (duloxetine) 60 mg as low as $0.48 per tablet at a verified international pharmacy by comparing prices on PharmacyChecker.com. That's a 60% discount vs. generic duloxetine sold in the U.S. 

SAVINGS TIP: Usually, patients can find much lower prices on the generic version of popular anxiety medicine at their local pharmacy in the U.S.

Here are some more brand drug price comparisons:

  Brand Anxiety Medications are Cheaper from Verified Online Pharmacies  
Drug Quantity Local U.S. Pharmacy Price Lowest Price at PharmacyChecker-verified Pharmacies Estimated Savings
Effexor XR 75mg 30 $552.50 $37.95 93% saved
Paxil 20mg 30 $241.32 $45.91 81% saved
Lexapro 10mg 30 $389.15 $28.95 93% saved

Generic medications are often cheaper at your local pharmacy, such as CVS or Costco or your neighborhood mom and pop pharmacy, than abroad.

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Benzodiazepines and Other Anxiety Medication Local Pharmacy Savings

PharmacyChecker-verified international online pharmacies will not ship benzodiazepines and other controlled drugs to patients in the U.S.

For many controlled drugs, such as generic Ambien (diazepam) and generic Ativan (lorazepam), you can find very low prices at local U.S. pharmacies using a prescription discount card. If you prefer to shop at your local U.S. pharmacy for anxiety medications, including benzodiazepines, just scroll to the bottom of the price comparison page for that particular drug. You'll see a box that says "Find Prices at U.S. Local Pharmacies." Enter your ZIP Code to find the discounts available in your area. Follow the prompts to print the discount coupon for your chosen local pharmacy.

PharmacyChecker.com also offers a search tool for patient assistance programs. Many pharmaceutical companies offer aid with the cost of medications through patient assistance programs. Search for a program that may help you afford your medication using the following link: 

Patient Assistance Programs

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Compare drug prices among reputable online pharmacies

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