There is no single "best" anxiety medication and, importantly, no proven over-the-counter one — effective treatment is prescription medicine, talking therapy, or both, chosen with a clinician. Health authorities lead with therapy: the NHS says a GP "will usually advise you to try talking therapies before they prescribe medicine," and cognitive behavioural therapy (CBT) is a main talking therapy used for generalised anxiety disorder (GAD). When medication is used, the NHS notes it is "usually a type of antidepressant called an SSRI," and SSRIs such as sertraline and escitalopram are typically the first medicine tried because their side effects are generally easier to manage. MedlinePlus adds that both antidepressants and anti-anxiety medicines have a role, that some medicines work better for particular anxiety disorders, and that a person "may need to try more than one medicine" before finding the right fit. Other prescription options include SNRIs (venlafaxine, duloxetine), the anti-anxiety drug buspirone, the antihistamine hydroxyzine, and — for short-term use only — benzodiazepines, which MedlinePlus warns can be habit-forming. Supplements and herbal "calm" products are not proven anxiety treatments and some can interact with antidepressants, so they are not listed as options here.
For options we rate, we show our independent FDA recall-safety rating(0–100) — a signal GoodRx and Drugs.com don’t provide. Higher is safer.
A doctor may prescribe these — not for self-treatment.
Zoloft SSRI (selective serotonin reuptake inhibitor) Our rating 68/100 | An SSRI that increases serotonin in the brain. Per the NHS, an SSRI is usually the first medicine prescribed for anxiety because side effects are generally easier to manage; it is taken daily and can take a few weeks to work. Your doctor decides whether it is appropriate, which one, and what dose. |
Lexapro SSRI (selective serotonin reuptake inhibitor) Our rating 70/100 | Another commonly used SSRI for anxiety and depression, taken once daily. Like other SSRIs it builds up over several weeks rather than working on the spot. A clinician chooses between SSRIs based on side effects, other medicines you take, and your history. |
Effexor XR SNRI (serotonin-norepinephrine reuptake inhibitor) | An SNRI that raises both serotonin and norepinephrine; MedlinePlus lists it for generalised anxiety disorder, social anxiety disorder, and panic disorder. Often considered when an SSRI has not helped or is not tolerated — a decision the prescriber makes. |
Because no drug is best for everyone, a clinician matches the option to the person. Per the NHS, talking therapy such as CBT is usually offered first and can be used on its own or alongside medicine. If medication is considered, an SSRI (for example sertraline or escitalopram) is typically the first choice because its side effects are generally more manageable; if one SSRI does not help or is not tolerated, MedlinePlus notes a person may need to try a different medicine, such as another SSRI or an SNRI like venlafaxine or duloxetine. Buspirone is an option taken regularly for ongoing anxiety, and hydroxyzine — a non-controlled antihistamine — can be used as needed. Benzodiazepines such as alprazolam or lorazepam work quickly, but MedlinePlus warns they can be habit-forming, so they are generally reserved for short-term or occasional use and are used cautiously in people with a history of alcohol or substance use. The clinician weighs the type of anxiety, other health conditions, other medicines you take, pregnancy, side-effect profiles, and your preferences — which is why the choice of drug, the dose, and how long to take it are decisions to make together with a prescriber, not on your own.
If you ever have thoughts of suicide or self-harm, get help right now: call or text the 988 Suicide & Crisis Lifeline (call or text 988) in the US, available 24/7, or call 911 or go to the nearest emergency room. Otherwise, see a doctor if anxiety is persistent, hard to control, or interferes with work, sleep, relationships, or daily life — that is when a clinician can assess for an anxiety disorder and discuss talking therapy and/or medicine. Seek prompt care for sudden, intense episodes of fear with a pounding heart, chest pain, shortness of breath, dizziness, or a feeling of losing control (panic attacks), since these symptoms can overlap with heart or other medical problems that need to be ruled out. Also talk to a doctor before stopping any anxiety medicine — MedlinePlus warns that benzodiazepines like alprazolam should not be stopped abruptly and are usually tapered — and reach out promptly if you notice worsening mood, new or increasing thoughts of self-harm, or troubling side effects after starting an antidepressant.
General reference, not medical advice, and not a substitute for your doctor or pharmacist. The right choice depends on your symptoms, health conditions, age, and other medicines — always read each label and confirm before taking anything.
Cymbalta SNRI (serotonin-norepinephrine reuptake inhibitor) | An SNRI approved for generalised anxiety disorder that is also used for depression and certain chronic pain conditions, which can matter when both are present. Taken daily; the prescriber weighs it against the other options. |
BuSpar Anxiolytic (non-benzodiazepine) Our rating 72/100 | A non-benzodiazepine anti-anxiety medicine used specifically for ongoing anxiety. Unlike benzodiazepines it is taken regularly rather than as-needed and, per MedlinePlus, may take several weeks to reach an effective dose; it is not a controlled substance. |
Vistaril, Atarax Antihistamine (prescription) Our rating 56/100 | A prescription antihistamine that MedlinePlus says is used to relieve anxiety and tension; it also calms activity in the brain, which causes drowsiness. It can be used as-needed, is not a controlled substance, and is sometimes chosen when a non-habit-forming as-needed option is wanted. |
Xanax Benzodiazepine Our rating 70/100 | A fast-acting benzodiazepine used for anxiety disorders and panic disorder. MedlinePlus warns it "may be habit-forming," so it is generally used only short-term and stopped gradually under a doctor's guidance rather than abruptly. |
Ativan Benzodiazepine Our rating 70/100 | Another fast-acting benzodiazepine used for anxiety and, like alprazolam, carrying dependence risk with regular use. Generally reserved for short-term or occasional use and tapered rather than stopped suddenly — decisions a prescriber manages. |