When and how to take anti-anxiety medication?

Anxiety can affect both the mind and body. For some people, it shows up as persistent worry or racing thoughts, while for others it causes physical symptoms like chest tightness, stomach discomfort, or a pounding heart.

For many Australians living with anxiety, medication can offer meaningful relief, especially when symptoms start interfering with work, relationships, or day-to-day life.

A note on medications

Anti-anxiety medications can be an important part of treatment, but they’re not a one-size-fits-all solution. These medications are prescribed based on each person’s symptoms, history, and treatment goals. They should always be taken under medical supervision.

It’s important to remember:

• While anti-anxiety meds help reduce anxiety symptoms, they don’t treat the underlying causes of your anxiety.

• Some anxiety medications take time to work, and side effects can vary from person to person.

• Medication should not be started, stopped, or adjusted without talking to a GP or psychiatrist.

Should you take anxiety pills right away?

Using medication shouldn’t be your first resort. For many people, psychological therapy alone already does wonders. For others, combining medication with therapy and lifestyle strategies offers the best results.

Here are some examples of non-medication strategies for anxiety:

• Cognitive Behavioural Therapy (CBT), one of the most effective psychological treatments for anxiety.

• Physical activity, which has been shown to reduce anxiety levels and improve overall wellbeing.

• Relaxation techniques, including deep breathing, mindfulness, and grounding exercises.

• Limiting caffeine and alcohol, which can worsen anxiety symptoms.

• Improving sleep routines, as poor sleep often heightens anxiety.

• Support from trusted people, including friends, family, peer groups, or mental health professionals.

Different anti-anxiety medications

There are several types of medications used to treat anxiety. Each one works in a different way, and what suits one person may not suit another. Below is an overview of the most commonly prescribed options in Australia.

1. Beta-blockers

Beta-blockers help control physical symptoms of anxiety by reducing the effects of adrenaline on the body. They’re particularly useful in situations like public speaking or social events where physical symptoms, such as a racing heart or shaky hands, can be distressing. 

They don’t affect psychological symptoms of anxiety and aren’t used as a long-term solution for anxiety disorders, but they can offer targeted relief when needed.

Examples: Propranolol (Inderal)

2. Benzodiazepines

Benzodiazepines work by increasing the activity of GABA, a neurotransmitter that helps calm the brain. This leads to a rapid reduction in anxiety, often within an hour.

These medications are particularly helpful for sudden, intense episodes such as panic attacks or acute stress. However, they’re not suitable for long-term use, as they can cause drowsiness, memory problems, and dependence. In Australia, they’re typically prescribed for short periods or no more than two to four weeks.

Examples: Diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan)

3. SSRIs (Selective Serotonin Reuptake Inhibitors)

SSRIs increase the amount of serotonin available in the brain, which helps regulate mood, sleep, appetite, and emotional responses. They are one of the first-line treatments for generalised anxiety disorder (GAD), panic disorder, and social anxiety. Although they don’t work instantly, many people begin to feel improvements within a few weeks. SSRIs are usually well tolerated and suitable for long-term treatment, though they may cause side effects such as nausea or changes in sleep or libido.

Examples: Sertraline (Zoloft), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil)

4. SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors)

SNRIs affect both serotonin and norepinephrine, two neurotransmitters that influence mood and physical symptoms of anxiety. These medications are often used when SSRIs haven’t worked well, or when anxiety occurs alongside chronic pain or fatigue.

They are effective for generalised anxiety and often help people who also experience low mood. Side effects can include increased blood pressure, dizziness, or nausea.

Examples: Venlafaxine (Effexor), duloxetine (Cymbalta)

5. Buspirone

Buspirone interacts with serotonin and possibly dopamine in the brain, though its exact mechanism is still being studied. It’s used for generalised anxiety and is a good option for people who don’t want the sedation or dependency risks associated with benzodiazepines. 

Buspirone doesn’t work immediately. It typically takes a few weeks to build up its effect, but it can provide steady relief with a lower side effect profile. It’s not yet widely prescribed in Australia, but it is gaining recognition as a safer long-term option.

6. Tricyclic antidepressants (TCAs)

TCAs increase levels of serotonin and norepinephrine, similar to SNRIs, but they also affect other brain chemicals. They can be effective for anxiety, especially when depression or obsessive-compulsive symptoms are also present.

However, they’re less commonly prescribed due to a higher risk of side effects such as constipation, dry mouth, and weight gain. TCAs are generally used when newer medications haven’t been effective.

Examples: Clomipramine (Anafranil), imipramine (Tofranil)

7. MAOIs (Monoamine Oxidase Inhibitors)

MAOIs work by blocking the breakdown of neurotransmitters like serotonin, dopamine, and norepinephrine, which can help regulate mood and anxiety. They are very effective but come with strict dietary rules and interactions with other medications.

MAOIs are typically used only when other treatments haven’t worked, and they require careful monitoring. Because of their potential risks, they are rarely used as a first choice.

Examples: Phenelzine (Nardil), tranylcypromine (Parnate)

Moving forward with care

Medication can make anxiety more manageable, but it’s rarely the only answer. Most people benefit from a comprehensive plan that includes therapy, lifestyle changes, and regular check-ins with health professionals.

Finding the right combination takes time and often involves trial and error, but the process is worth it.

If you're considering medication, speak openly with your GP or mental health professional about your symptoms, concerns, and goals. Together, you can weigh the benefits, risks, and what suits your individual situation. With the right support, it's possible to find relief and regain balance in your life.