Selective serotonin-reuptake inhibitors (SSRIs), or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor, generic), are the primary first-line treatment for anxiety disorders. For patients who are not helped by these drugs or who need help rapidly, benzodiazepines may be prescribed, either alone or in combination with an antidepressant. Other types of antidepressants, including tricyclic antidepressants, may also be used to treat patients with severe or chronic forms of anxiety disorders.
Drug therapies for anxiety disorders work best in combination with cognitive behavioral therapy or some other form of psychotherapy.
Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs include fluoxetine (Prozac, generic), sertraline (Zoloft, generic), paroxetine (Paxil, generic), fluvoxamine (Luvox, generic), citalopram (Celexa, generic), and escitalopram (Lexapro).
SSRIs can cause agitation, nausea, and diarrhea. Sexual dysfunction, including lowered sex drive, is a common side effect of many antidepressants as is weight gain. Elderly people taking these drugs should take the lowest effective dose possible, and those with heart problems should be monitored closely.
Antidepressants may raise the risk for suicidality (suicidal thoughts and behavior) in young people, particularly those ages 18 - 24. Both adults and children who are treated with SSRIs should be carefully monitored for any worsening of depressive symptoms or changes in behavior. This is especially important during the first few months of antidepressant treatment.
Review Date: 01/27/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.