Medication and Other Treatment Options for Anxiety Disorders and Depression

Medication can be a safe, effective, and evidence-based option for treating anxiety disorders and depression. Many people take medication alone or in combination with therapy to help manage symptoms and improve daily functioning.

It's essential to recognize that medication is only one component of a comprehensive treatment approach. Other evidence-based options, such as psychotherapy, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT), may be recommended depending on an individual’s needs and treatment goals. These approaches can be used alone or in combination with medication to maximize effectiveness.

Finding the right medication or treatment plan often requires patience, collaboration with a healthcare provider, and adjustments along the way. When used appropriately, medications can significantly reduce symptoms of anxiety and depression and support a return to balance and quality of life.

Always consult a healthcare provider before starting, changing, or stopping medication. The right treatment depends on your symptoms, medical history, and individual needs. Finding the right medication—whether antidepressants, anti-anxiety medications, or a combination, often takes time, patience, and close collaboration with your doctor or nurse practitioner.

Discussing Medications - What You Need to Know:

Use these guidelines to talk to your health care professional about medications:

To avoid potentially dangerous drug interactions, let your mental health care provider know all medications you are taking, including prescriptions and over-the-counter drugs, herbal or dietary supplements, and vitamins. And make sure your family doctor knows you are taking medicines for an anxiety disorder.
Learn when to take a new medication and how, such as on an empty stomach or with food, in the morning or evening, and how frequently.
Find out how long it should take for the medication to start working and what you should expect when this happens.
Ask: How will the medication help me? What side effects might occur? Should I avoid any foods or beverages? Are drug interactions with other prescriptions a possibility? How often should you see the doctor for a medication check-up?
Ask for the prescribing physician’s after-hours phone number in case you develop side effects.
A good source of information about medications and over-the-counter products is your pharmacist, who should have information about all your prescriptions to advise you about possible drug interactions, side effects, and instructions for use.

If your physician does not want to spend the time to answer your questions, you may need a referral to a different physician.

Medications are commonly prescribed by physicians (family practice, pediatricians, OB-GYNs, psychiatrists), as well as nurse practitioners in many states.

There are four major classes of medications that are used in the treatment of anxiety disorders:

Q&A

What to Ask Your Doctor Before Starting a New Antidepressant or an Emerging Treatment

Is this new drug/treatment appropriate for me?
What are the drawbacks, if any of this new treatment?
What might be the benefits over my current regimen?
Is the price (typically high when a drug is new) worth the added benefit?
Is this treatment ready for widespread use? Meaning, does it have safety established? Do we know how long people need to be on this treatment? Do we know about any long term issues that could result from this?

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs relieve symptoms by blocking the reabsorption, or reuptake, of serotonin by certain nerve cells in the brain. This leaves more serotonin available, which improves mood. SSRIs (citalopram, escitalopram, fluoxetine, paroxetine, and sertraline) generally produced fewer side effects when compared with tricyclic antidepressants. However, common side effects include insomnia or sleepiness, sexual dysfunction, and weight gain. They are considered an effective treatment for all anxiety disorders, although the treatment of obsessive-compulsive disorder, or OCD, typically requires higher doses. Read this blog about SSRIs and Benzodiazepines.

Trintellix (vortioxetine) is a prescription antidepressant used to treat major depressive disorder in adults. It works by affecting serotonin activity in the brain, which can help improve mood, cognition, and overall functioning.
Viibryd (vilazodone) is a prescription antidepressant used to treat major depressive disorder (MDD) in adults. It works by increasing serotonin activity in the brain and is classified as a selective serotonin reuptake inhibitor (SSRI) and partial serotonin receptor.

To learn more in-depth about Selective Serotonin Reuptake Inhibitors (SSRIs), check out ADAA's Patient Guide to Mood and Anxiety Disorders.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

The serotonin-norepinephrine reuptake inhibitor, or SNRI, class (venlafaxine and duloxetine) is notable for a dual mechanism of action: increasing the levels of the neurotransmitters serotonin and norepinephrine by inhibiting their reabsorption into cells in the brain. As with other medications, side effects may occur, including stomach upset, insomnia, headache, sexual dysfunction, weight gain and minor increase in blood pressure. These medications are considered as effective as SSRIs, so they are also considered a first-line treatment for the treatment of anxiety disorders, but not for obsessive compulsive disorder, where SSRI’s are the preferred first line treatment.

Pristiq is used to treat major depressive disorder in adults. It works by increasing levels of serotonin and norepinephrine in the brain to help improve mood, energy, and interest in daily activities.
Fetzima is prescribed for major depressive disorder in adults. It helps balance serotonin and norepinephrine, with a relatively stronger effect on norepinephrine, which may improve mood, concentration, and physical energy.

To learn more in-depth about Selective Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), check out ADAA's Patient Guide to Mood and Anxiety Disorders.

Benzodiazepines

This class of drugs is frequently used for short-term management of anxiety and as an add on treatment, in treatment resistant anxiety disorders. They are not recommended as a treatment for Post Traumatic Stress Disorder. Benzodiazepines (alprazolam, clonazepam, diazepam, and lorazepam) are highly effective in promoting relaxation and reducing muscular tension and other physical symptoms of anxiety. Long-term use may require increased doses to achieve the same effect, which may lead to problems related to tolerance and dependence. Read this blog post about SSRIs and Benzodiazepines.

To learn more in-depth about Benzodiazepines, check out ADAA's Patient Guide to Mood and Anxiety Disorders.

Tricyclic Antidepressants

Concerns about long-term use of the benzodiazepines led many doctors to favor tricyclic antidepressants (amitriptyline, imipramine, and nortriptyline). Although effective in the treatment of some anxiety disorders(but not Social Anxiety Disorder), they can cause significant side effects, including orthostatic hypotension (drop in blood pressure on standing), constipation, urinary retention, dry mouth, and blurry vision.

Contact your physician if you experience side effects, even if you are not sure a symptom is caused by a medication. Do not stop taking a medication without consulting with the prescribing physician; abrupt discontinuation may cause other health risks.

To learn more in-depth about Tricyclic Antidepressants, check out ADAA's Patient Guide to Mood and Anxiety Disorders.

Emerging Medications

Ketamine (Esketamine)

Ketamine represents a major step forward in the treatment of depression and suicide prevention. Read ADAA's Public Statement regarding 2019 FDA approved nasal spray medication- Spravato (esketamine) for treatment resistant depression, available only at a certified doctor’s office or clinic.

To learn more in-depth about Ketamine (Esketamine), check out ADAA's Patient Guide to Mood and Anxiety Disorders.

Ketamine: A Rising Star in Mental Health Treatment, ADAA blog post
Ketamine Fact Sheet (Infographic)
Researchers discover positive effects of intravenous ketamine for treatment-resistant depression, Baylor College of Medicine, Sanjay Mathews, MD

Additional Research Studies About Ketamine and Psychedelics: Posted April 2021

AMJ Psychiatry 2020 Issue: Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation, Roger S. McIntyre, M.D., Joshua D. Rosenblat, M.D., M.Sc., (ADAA President Elect and CMO) Charles B. Nemeroff, M.D., Ph.D., Gerard Sanacora, M.D., Ph.D., (ADAA member) James W. Murrough, M.D., Ph.D., Michael Berk, Ph.D., M.B.B.Ch., Elisa Brietzke, M.D., Ph.D., Seetal Dodd, Ph.D.,Philip Gorwood, M.D., Ph.D., Roger Ho, M.D., M.B.B.S., Dan V. Iosifescu, M.D., Carlos Lopez Jaramillo, M.D., Ph.D., Siegfried Kasper, M.D., Kevin Kratiuk, B.Pharm., Jung Goo Lee, M.D., Ph.D., Yena Lee, H.B.Sc., Leanna M.W. Lui, Rodrigo B. Mansur, M.D., Ph.D., George I. Papakostas, M.D., Mehala Subramaniapillai, M.Sc., (ADAA member) Michael Thase, M.D., Eduard Vieta, M.D., Ph.D., Allan H. Young, M.Phil., M.B.Ch.B., Carlos A. Zarate, Jr., M.D., Stephen Stahl, M.D., Ph.D.

In this article, an international group of mood disorder experts provides a synthesis of the literature with respect to the efficacy, safety, and tolerability of ketamine and esketamine in adults with treatment-resistant depression. The authors also provide guidance for the implementation of these agents in clinical practice, with particular attention to practice parameters at point of care. Areas of consensus and future research vistas are discussed.

A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders, JAMA Psychiatry, April 2017, Gerard Sanacora, MD, PhD; Mark A. Frye, MD; William McDonald, MD; ADAA Board Member Sanjay J. Mathew, MD; Mason S. Turner, MD; ADAA member Alan F. Schatzberg, MD; Paul Summergrad, MD; ADAA Board Member and Chief Medical Officer Charles B. Nemeroff, MD, PhD; for the American Psychiatric Association (APA) Council of Research Task Force on Novel Biomarkers and Treatments

Medical Marijuana/Cannabis/CBD

Can CBD Help with My Anxiety and Depression? ADAA blog post

Psychedelics

Several psychedelic medicines including psilocybin and MDMA are undergoing FDA-regulated clinical trials for treatment-resistant depression, PTSD, and related conditions. However, as of late 2025, none have received U.S. regulatory approval and they remain classified as DEA Schedule 1 drugs.

As this is a rapidly evolving area, ADAA is committed to providing timely updates on this topic as new data emerges. Learn more:

Psychedelic Therapy: Promises and Problems, ADAA Professional Webinar (Recorded live October 27,2022)
How MDMA Resensitizes the Brain, Nature, September 28, 2022
Psychedelics and Psychedelic-Assisted Psychotherapy. AMJ Psychiatry 2020 Issue: Collin M. Reiff, M.D., Elon E. Richman, M.D., (ADAA President Elect and CMO) Charles B. Nemeroff, M.D., Ph.D., Linda L. Carpenter, M.D., Alik S. Widge, M.D., Ph.D., Carolyn I. Rodriguez, M.D., Ph.D., (ADAA member) Ned H. Kalin, M.D., William M. McDonald, M.D., and the Work Group on Biomarkers and Novel Treatments, a Division of the American Psychiatric Association Council of Research
- Objective: The authors provide an evidenced-based summary of the literature on the clinical application of psychedelic drugs in psychiatric disorders.
- Results: The most significant database exists for MDMA and psilocybin, which have been designated by the U.S. Food and Drug Administration (FDA) as “breakthrough therapies” for posttraumatic stress disorder (PTSD) and treatment-resistant depression, respectively. The research on LSD and ayahuascais observational, but available evidence suggests that these agents may have therapeutic effects in specific psychiatric disorders.
- Conclusions: Randomized clinical trials support the efficacy of MDMA in the treatment of PTSD and psilocybin in the treatment of depression and cancer-related anxiety. The research to support the use of LSD and ayahuasca in the treatment of psychiatric disorders is preliminary, although promising. Overall, the database is insufficient for FDA approval of any psychedelic compound for routine clinical use in psychiatric disorders at this time, but continued research on the efficacy of psychedelics for the treatment of psychiatric disorders is warranted.
To learn more in-depth about medications, check out ADAA's Patient Guide to Mood and Anxiety Disorders.

Medications That Can Help with Obsessive–Compulsive Disorder (OCD)

Medications can help reduce the symptoms of obsessive–compulsive disorder (OCD). The most prescribed are a type of antidepressant called SSRIs (selective serotonin reuptake inhibitors) (see above). Although their name suggests they are only for depression, SSRIs are also effective in treating OCD. These medicines work by helping to balance brain chemicals that affect mood, anxiety, and repetitive thoughts or behaviors.
It may take several weeks to start noticing improvements. Your doctor will work with you to find the right dose, explain possible side effects, and answer any questions you have. Medication is often most effective when combined with therapy, especially cognitive behavioral therapy (CBT) that is designed for OCD.

ADAA Resources

The Role of Antipsychotics in OCD
Medication for Treatment of OCD: Understanding the Options
What is Obsessive- Compulsive Disorder? (website page)
What is Obsessive-Compulsive Disorder (OCD)? (short video)
To learn more in-depth about OCD and medication, check out ADAA's Patient Guide to Mood and Anxiety Disorders.

Medications and Cognitive Behavioral Therapy (CBT) for Postpartum Depression

Postpartum depression can be treated with certain antidepressant medicines that help balance brain chemicals linked to mood. These medicines can ease sadness, worry, and low energy, making it easier for new parents to feel better and care for themselves and their baby.

In addition to medication, Cognitive Behavioral Therapy (CBT) is a highly effective treatment for postpartum depression. CBT helps individuals recognize and change unhelpful thought patterns, develop healthier coping strategies, and build problem-solving skills. It focuses on the connection between thoughts, emotions, and behaviors, empowering new parents to manage stress, reduce negative thinking, and improve overall well-being.

Learn more about CBT and other therapy types
Learn more about postpartum disorders
Learn about postpartum depression
What is Postpartum Depression? (ADAA Video)
Watch ADAA's Video on CBT
The Wisdom of Cognitive Behavioral Therapy (CBT): The Perfect Gift for New Moms
To learn more in-depth about Postpartum Depression and medication, check out ADAA's Patient Guide to Mood and Anxiety Disorders.

Brain Treatments for Anxiety and Depression

Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS) are brain treatments that may help people with depression and anxiety when other treatments, like medicine or talk therapy, have not worked.

Electroconvulsive therapy (ECT) is useful for patients who are not responding well to medications or are suicidal. ECT is an effective treatment for patients who do not respond to drug therapy, are psychotic, or are suicidal or dangerous to themselves. Onset of action may be more rapid than that of drug treatments, with benefit often seen within one week of commencing treatment. The indications for the use of ECT include the following:

Failure of drug therapies
History of good response to ECT
Patient preference
High risk of suicide
High risk of medical morbidity and mortality

Although advances in ECT treatment has improved the safety and tolerability of this modality there are some risks such as those associated with postictal confusion, and, more rarely, short-term memory difficulties.

Transcranial Magnetic Stimulation, known as TMS or rTMS, may be a safe, effective, and noninvasive option for people who have depression that has not improved with medications. TMS creates a magnetic field to induce a small electric current in a specific part of the brain; the current comes from the magnetic field created by an electromagnetic coil that delivers pulses through the scalp. TMS is an FDA-approved treatment and recently (June 2019), the Brainsway Deep TMS device was approved for the treatment of OCD. There is ongoing research on the use of TMS to treat PTSD and other mental health conditions.

TMS does not require sedation, is non-invasive and is virtually pain-free. With modern safety techniques, there is a less than 0.1% risk of seizure or loss of consciousness with TMS. Those receiving TMS usually are treated four or five times every week for four to six weeks. Research shows that TMS produces few side effects. Each treatment session lasts about 40 minutes. A new form of TMS called theta burst stimulation was recently approved by the FDA for the treatment of depression; sessions of theta burst stimulation last only about 10 minutes but still are provided daily for several weeks.

To find out if TMS is the right treatment for you, speak to your therapist, doctor, or other mental health treatment provider. Your insurance may provide reimbursement for this treatment.

Learn more about TMS
To learn more in-depth about TMS check out ADAA's Patient Guide to Mood and Anxiety Disorders.

ADAA Medication Information Resources

Psychiatric Medication in Pregnancy and Lactation: What Can Women Take?, ADAA webinar
Dear ChatGPT, Can You See Me? The Limits of AI in Healing Anxiety and Emotional Pain, ADAA blog post
Medication for Treatment of OCD: Understanding the Options, ADAA blog post
SSRIs and Benzodiazepines for General Anxiety Disorders (GAD), ADAA blog post
Anxiety Medication Guide for Parents, AACAP.org, written by ADAA member John Walkup, MD
Can CBD Help with My Anxiety and Depression? - ADAA web page
Psychotropic Medications: What You Should Ask Your Doctor - ADAA blog post
For My Anxiety or Depression: Should I Use Medication or Therapy - ADAA webinar
Generalized Anxiety Disorder (GAD) - ADAA Brochure
Depression - ADAA Brochure
Learn about mental health therapy types
Visit ADAA's Find Your Therapist Directory to find a provider near you
To learn more about medication and mental health therapy types check out ADAA's Patient Guide to Mood and Anxiety Disorders.

Important Resources and Patient Assistance Programs

Most pharmaceutical companies offer patient-assistance programs for uninsured patients. These programs provide prescribed medication at little to no cost. Eligibility varies; see the Partnership for Prescription Assistance website for more information, or contact companies directly about their patient assistance programs.

A New Patient Assistance Program Offering from Janssen. For Insured Patients Who Are Facing Access and Affordability Challenges. A Quick Reference Guide
NeedyMeds is a 501(c)(3) national non-profit information resource dedicated to helping people locate assistance programs to help them afford their medications and other healthcare costs.

Alliance for Safe Online Pharmacies

The Alliance for Safe Online Pharmacies (ASOP Global), a 501(c)(4) non-profit organization is dedicated to protecting consumers around the world, ensuring safe access to medications, and combating illegal online drug sellers.

Visit ADAA's Find Your Therapist Directory to find a provider near you

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