Anxiety Medication Options: What Works, What Doesn’t, and What to Avoid

If anxiety impacts your sleep, work, or relationships, you may wonder which treatments truly help—and what to avoid. At Dignity Brain Health, we offer expert psychiatric medication management via tele‑psychiatry to residents of Massachusetts, New Hampshire, and Florida, including Boston-area neighborhoods like Brookline, Cambridge, Newton, Somerville, and Back Bay.

Here’s an evidence-based guide to anxiety medication options, risks, and how to get personalized care online.

Why Medication May Be Helpful for Anxiety

For anxiety disorders—including GAD, panic disorder, and social anxiety—medications can:

  • Reduce chronic worry and physical symptoms

  • Improve sleep, energy, and concentration

  • Help you function more effectively

Meta-analyses confirm that SSRIs, SNRIs, and benzodiazepines outperform placebo in anxiety reduction (Strawn et al., 2018; Gomez et al., 2018; Mendez et al., 2024).

First-Line Medications: SSRIs & SNRIs

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs (e.g., sertraline, escitalopram, paroxetine) are considered first-line treatment for anxiety disorders due to their strong efficacy and tolerability (DeGeorge et al., 2022; Strawn et al., 2018).

Serotonin‑Norepinephrine Reuptake Inhibitors (SNRIs)

Venlafaxine and duloxetine act on both serotonin and norepinephrine and offer similar efficacy to SSRIs in treating anxiety (DeGeorge et al., 2022; Strawn et al., 2018).


Are Benzodiazepines Wise? Use With Caution

While benzodiazepines like alprazolam, lorazepam, and clonazepam provide fast relief, they come with higher risk for dependence and cognitive impairment. Meta‑analysis shows benzodiazepines have a larger short‑term effect size (g ≈ 0.50) versus SSRIs (g ≈ 0.33) and SNRIs (g ≈ 0.36) in GAD (Strawn et al., 2018).

By week eight, however, benefits between these classes converge (Mendez et al., 2024).

At Dignity Brain Health, we do not recommend long term use of benzodiazepines for anxiety due to health risks and side effects.


Buspirone & Hydroxyzine: Alternatives to Benzos

Buspirone

Buspirone is FDA-approved for GAD, with no dependence risk and a 2–4 week onset. A Cochrane review found it superior to placebo, though less potent than benzodiazepines or antidepressants (Garakani et al., 2020).

Hydroxyzine

In clinical trials, hydroxyzine significantly outperformed placebo in reducing anxiety (Lader & Scotto, 1998), and may be comparable to benzodiazepines and buspirone in short-term efficacy (Rudolph & Liegl, 2020).


Comparing Treatment Options: What Works Best

  • SSRIs and SNRIs: First-line choices, ideal for long-term management.

  • Benzodiazepines: Effective short-term, best used briefly and carefully.

  • Buspirone: Non-addictive but slower acting—best as augmentation or mild chronic option.

  • Hydroxyzine: Useful for acute, situational anxiety—but causes sedation.

Meta-analytic evidence (DeGeorge et al., 2022; Strawn et al., 2018) supports SSRIs/SNRIs as standard therapy, reserving benzodiazepines for acute relief with caution.

What to Avoid or Use with Caution

  • Avoid long-term benzodiazepine use due to tolerance and withdrawal risks (DeGeorge et al., 2022).

  • Beta-blockers like propranolol may help performance anxiety but don’t treat general anxiety symptoms.

  • Older antidepressants (TCAs, MAOIs) are rarely used due to side-effect burden unless other treatments fail.

How We Help: Personalized Online Care

At Dignity Brain Health:

  • Licensed providers conduct a detailed virtual evaluation (symptoms, medical history, GAD‑7 or HAM‑A)

  • A personalized plan may include SSRI/SNRI initiation, optional buspirone or hydroxyzine, or genetic testing (learn more)

  • Follow-up visits occur every 2–4 weeks initially to assess response

  • Serving Massachusetts residents—including Boston, Brookline, Cambridge, Newton, Somerville, and Back Bay


Frequently Asked Questions

Can I get anxiety meds without therapy?

Yes—medication-only treatment is fully supported at Dignity Brain Health.

Is telehealth prescribing legal in Massachusetts?

Yes. All providers are licensed in MA, FL, and NH, and our platform is HIPAA compliant.

Will anxiety medications change my personality?

No. Most patients report feeling calmer and more present—still themselves.


Local Mental Health Resources in Massachusetts


🧠 Conclusion: Smart, Safe Anxiety Relief

For effective anxiety treatment:

  1. Start with SSRIs or SNRIs for sustained, well-tolerated relief

  2. Use benzodiazepines short-term only, under careful supervision

  3. Buspirone or hydroxyzine are non-addictive alternatives—though slower acting

  4. Combine medication and therapy for optimal results when needed

At Dignity Brain Health, we provide expert medication management tailored to Massachusetts residents—from Cambridge to Back Bay—all through seamless online care..


👉 Start your your online psychiatric medication consultation process now


🔍 References (APA Format)

DeGeorge, K. C., et al. (2022). Treatment of generalized anxiety and panic disorders: SSRIs and SNRIs as first-line therapy. American Family Physician, 106(4), 456–464. https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html Verywell Mindstaging-mobile.health.mil+2Cambridge University Press & Assessment+2PubMedCDA AMCFrontiersLippincott Journals+1TalkspaceOHSU+1AAFP+2AAFP+2

Garakani, A., Murphy, K., & Katz, I. (2020). Pharmacotherapy of anxiety disorders. Psychiatric Clinics of North America, 43(3), 403–419. PMC

Gomez, A. F., Guidi, J., Tomba, E., & Fava, G. A. (2018). Comparing the efficacy of benzodiazepines and serotonergic antidepressants in adults with generalized anxiety disorder: A meta‑analytic review. Expert Opinion on Pharmacotherapy, 19(8), 813–820. https://doi.org/10.1080/14656566.2018.1472767 PMC+1

Mendez, E. M., Mills, J. A., Suresh, V., Stimpfl, J. N., & Strawn, J. R. (2024). Trajectory and magnitude of response in adults with anxiety disorders: A Bayesian hierarchical modeling meta-analysis of SSRIs, SNRIs, and benzodiazepines. CNS Spectrums, 29(3), 187–196. https://doi.org/10.1017/S1092852924000142 Cambridge University Press & Assessment+1

Lader, M., & Scotto, J. C. (1998). A multicentre double-blind comparison of hydroxyzine, buspirone and placebo in patients with generalized anxiety disorder. Psychopharmacology (Berl), 139(4), 402–406. https://doi.org/10.1007/s002130050731 PubMed

Rudolph, M., & Liegl, S. (2020, August). In adults with generalized anxiety disorder, is hydroxyzine superior to placebo in reducing anxiety symptoms? Evidence-Based Practice, 23(8), 42–43. Lippincott Journals

Kristina BelarminoDignity Brain Health