Top 19 Non-Addictive Anxiety Medications

Anxiety refers to how your body reacts to stressful situations and circumstances. Everyone experiences anxiety when confronted with stressful situations. Stress will explicitly interfere with daily life and prevent the sufferer from engaging in previously enjoyed activities.

Anxiety disorders are the most common mental health disorder in the US, wherein 40 million adults are affected. Anxiety medications and non-pharmacological treatment are the most effective ways to control anxiety. 

Anti-anxiety medications are prescribed to millions of people to help relieve their debilitating symptoms. Benzodiazepines were among the first medications prescribed for anxiety. Although most drugs are addictive, the stigma associated with anxiety medication persists. Several non-controlled substance alternatives to benzodiazepines are currently available. 

Know about the non-addictive anti-anxiety drugs. Let us probe more into non-addictive anxiety medications in detail.

How Does Non- Addictive Medications Work?

Anti-anxiety drugs work on the brain and body that can help reduce anxiety symptoms like worry, fear, and panic attacks. The best anti-anxiety medications depend on your anxiety disorder, whether you have other health issues or consume other drugs.

Non-addictive medications have different effects on the brain. SSRIs, for example, work slowly on the serotonin system, whereas SRNIs work on both serotonin and norepinephrine. Long-term use of these medications is safer, whereas benzodiazepines become less effective over time.

What Makes Anxiety Medicines Addictive?

Addiction may begin in the brain. Specific neurological conditions predispose some people to addictive behaviors. Addictive drugs cause a surge of dopamine in the region of the brain called basal ganglia. When someone uses a substance repeatedly that increases dopamine, the brain learns to associate the rewarding feeling of the dopamine flood with the substance. It becomes more difficult to stop thinking about the drug as the cues become more linked to it. If our brains associate the use of the drug with pleasure, we will continue to seek it out.

The addictive potential of a drug varies depending on who is using it, how much it affects the dopamine system, and how pleasurable people say the substance is to use.

Controlled And Non-Controlled Anxiety Medications

Benzodiazepines, available in the 1960s, were among the first medications prescribed explicitly for anxiety. Well-known and the oldest "controlled substances" for anxiety are benzodiazepines like Xanax and Valium. While these drugs are quick and effective, they have a high risk of addiction, sedation, and tolerance buildup.

According to the USA Drug Enforcement Administration, "non-controlled" medications are drugs that do not pose a risk of dependence or addiction. There are several non-controlled substance alternatives to benzodiazepines available today.

Selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs) are two of the most commonly used non-controlled anxiety drugs.

Other non-controlled medications are as follows:

• Tricyclic antidepressants 
• Buspirone 
• Propranolol 
• Pregabalin 
• Hydroxyzine pamoate

One of the main differences between SSRIs and SNRIs compared to Benzodiazepines is that the former treats the source of the anxiety, whereas the latter only treats the symptoms.

What are the Non-Addictive Anxiety Medications?

Prescribing addictive benzodiazepines for anxiety without proper treatment may exacerbate addiction problems. Those with a substance abuse disorder and anxiety should consider non-addictive treatment options.

SSRIs

SSRIs (Selective serotonin reuptake inhibitors) are commonly prescribed medications for treating anxiety. SSRIs improve mood by inhibiting the reuptake of the hormone and the neurotransmitter serotonin.

It works by increasing the amount of serotonin in the brain, which results in improved mood and stress reduction. SSRIs are effective for GAD, phobias, and panic disorders. 
The drugs in this class include

• Fluoxetine

Fluoxetine is an antidepressant medication that has been in use since the 1980s. Clinical trials of Prozac for bipolar disorder have shown effectiveness in treating other anxiety symptoms. It is not habit-forming like benzodiazepine anxiety medications. Common side effects include anxiety, nervousness, headache, nausea, diarrhea, and dry mouth.

• Escitalopram

Lexapro or Escitalopram is the first choice for treating depression and anxiety. Doctors usually prescribe them orally once a day. Escitalopram (Lexapro) is available in tablet and liquid form. Some patients notice an improvement in their condition a week after beginning treatment.

Common escitalopram (Lexapro) side effects include nausea, difficulty sleeping, and drowsiness. These side effects may disappear or diminish over time for some people.

• Citalopram

Celexa or Citalopram is used to treat depression. It finds off-label use in treating anxiety. It could help with the symptoms of Generalized Anxiety Disorder (GAD). Citalopram for neuropathic pain has been proven. Celexa works in the brain by increasing serotonin levels. The most common side effects are nausea, dry mouth, difficulty sleeping, and increased sweating.

• Paroxetine

Paxil or Paroxetine is an antidepressant used to treat various adult mental health conditions such as depression, anxiety, and panic disorder. Paxil also treats PTSD. It raises serotonin levels in the brain, which can help with mood and anxiety. It comes in immediate-release (IR) and extended-release (ER) formulations.

• Sertraline

Apart from treating depression symptoms, Sertraline has been shown to reduce anxiety symptoms. Zoloft is the brand name for Sertraline. Sertraline treats anxiety by slowing serotonin reabsorption.

Zoloft does not relieve anxiety symptoms immediately after the first dose. It takes some time for the medication to begin blocking the process of serotonin recycling out of your system. It takes two to six weeks for anxiety symptoms to subside.

• Fluvoxamine

Fluvoxamine is used to treat anxiety symptoms. It aids in managing symptoms associated with Social Anxiety Disorder (SAD), Obsessive-Compulsive Disorder (OCD), and panic disorder. Nausea, drowsiness, weakness, diarrhea, anorexia, tremor, sweating, and sexual dysfunction are all possible side effects.

• Vilazodone

Vilazodone is marketed under the brand name Viibryd. The FDA approved it in 2011 to treat Major Depressive Disorder. Vilazodone is an SSRI and a partial 5-HT1A receptor agonist. Vilazodone may be effective for MDD and anxiety due to its serotonin reuptake inhibition and anxiolytic properties. Common side effects are diarrhea, nausea, dry mouth, headache, and increased sweating.

• Vortioxetine

Trintellix is a brand name for the drug- Vortioxetine. It regulates the neurotransmitter serotonin, which regulates mood, emotions, and appetite. Trintellix is used off-label to treat anxiety because serotonin is thought to help control pressure. It appears to be most effective in people with severe GAD. Side effects include nausea, vomiting, constipation, diarrhea, dry mouth, and muscle stiffness.

SNRIs 

(SNRIs) Serotonin and norepinephrine reuptake inhibitors work by inhibiting the reuptake of norepinephrine and serotonin. Norepinephrine improves your energy and focus. As a result, SNRIs can help you stabilize your mood and feel more energized. SNRIs are commonly used to treat generalized anxiety disorder and panic disorder. This class of drugs includes:

• Venlafaxine

Effexor or Venlafaxine is a medication used to treat depression and anxiety. It finds use in treating panic disorders, social phobia, and major depressive disorder. Venlafaxine for hot flashes is an off-label use.

Venlafaxine raises the levels of serotonin and norepinephrine in the brain. These neurotransmitters aid in the regulation of mood and energy. Common Effexor side effects include dizziness, blurred vision, fatigue, dry mouth, insomnia, etc.

• Duloxetine

Duloxetine, also known as Cymbalta, is used for Neuropathic pain, Major depression, and generalized anxiety disorder. Cymbalta works to restore the balance of neurotransmitters in the brain by preventing serotonin and norepinephrine from being reabsorbed into nerve cells.

It may take weeks for symptoms to improve. However, you may notice some early signs of relief from anxiety-related symptoms, such as better sleep, increased energy, and a healthier appetite. The most common side effect of duloxetine is nausea.

• Desvenlafaxine

Desvenlafaxine- known by the brand name- Pristiq. The FDA has approved Desvenlafaxine to treat MDD, and it does have a few off-label uses- including anxiety and panic disorder. The most common side effects are constipation, decreased appetite, diarrhea, dry mouth, fatigue, etc.

• Levomilnacipran

Levomilnacipran medications are used off-label as first-line treatments for generalized anxiety disorder. Common side effects are nausea, constipation, excessive sweating, vomiting, and sexual problems in males.

Tricyclic Antidepressants  

The FDA approves most tricyclic antidepressants (TCAs) for treating depression and anxiety. TCAs inhibit norepinephrine and serotonin reuptake, causing neurotransmitters to accumulate in the presynaptic cleft. Additionally, they inhibit postsynaptic histamine, alpha-adrenergic, and muscarinic-acetylcholine receptors. 

TCAs have effectively treated Obsessive-Compulsive Disorder, panic disorder, and post-traumatic stress disorder. Common side effects include blurred vision, dry mouth, constipation, urinary retention, tachycardia, tremor, weight gain, and sexual dysfunction.
Medicines Include Anafranil (clomipramine), Asendin (amoxapine), Elavil (amitriptyline), Norpramin (desipramine), and Pamelor (nortriptyline)

Beta-Blockers

The beta-blocker medication is another commonly used non-addictive medication used to treat anxiety temporarily. It works by blocking the effects of a specific hormone (adrenaline). Beta-blockers are not first-line anti-anxiety medications since they do not alter the brain's chemical balance.

Taking Beta blockers is a short-term solution due to the temporary results they produce. The drugs include Acebutolol, Atenolol, and Propranolol.

• Acebutolol

They are used as an anti-anxiety medication that is prescribed off-label. It can be effective for stage fright before performances, public speaking engagements, and sleep anxiety.

• Atenolol

It is most effective for dealing with short-term anxiety about specific events rather than long-term anxiety. It will not treat the underlying psychological causes of stress. Still, it will assist you in managing some of your body's physical reactions to pressure, such as a racing heart, trembling voice and hands, sweating, and dizziness.

• Propranolol

Propranolol helps to manage anxiety. Propranolol is widely recognized as an effective treatment for anxiety and is safe for an extended period. Propranolol can help relieve situational anxiety symptoms quickly. It can help reduce peripheral symptoms like sweating, tension, and tachycardia in as little as half an hour.

Other Medications

• Vistaril

Hydroxyzine is a non-addictive, fast-acting anxiety medication. It belongs to the drug class of antihistamines. The medicine balances the neurotransmitters (serotonin and histamine) that regulate mood by acting on histamine receptors. It is a short-term medication that can be used instead of benzodiazepines.

• Buspar 

Buspar or Buspirone is a non-addictive, non-narcotic medication that works similarly to an SSRI. But, it only affects one subtype of serotonin receptor in the brain, resulting in fewer side effects. The drug has a low dependence risk and no serious drug interactions. Buspar is used to treat Generalized Anxiety Disorder. The common side effects are dizziness, nausea, vomiting, and drowsiness. 

• Pregabalin

Pregabalin is an anti-seizure medication. They do, however, appear to have off-label uses for treating symptoms of generalized anxiety disorder. This medication inhibits the release of excitatory neurotransmitters such as glutamate, resulting in a calming and sometimes sleepy effect.

Non-Narcotic /Non-Addictive Holistic Treatment Options 

When a person is diagnosed with an anxiety disorder, they can begin to consider treatment options. Anxiety treatment comprises two categories: treatment options and psychotherapy/holistic treatment options. Here are some common holistic anxiety treatments that are safe and effective:

Cognitive Behavioural Therapy

Cognitive behavioral therapy (CBT) has emerged as the most effective treatment for anxiety. CBT addresses how a person's thoughts and behaviors interact to cause anxiety symptoms. 

It can help you change your negative thought patterns and feel better by making your problems more manageable. Therapists assist clients in recognizing how negative thought patterns influence feelings and behaviors.

Dialectical Behavioral Therapy

DBT provides clients with skills to tolerate extreme emotions and further guidance on how to apply these skills through individual weekly psychotherapy, skills groups, and phone coaching.

DBT has four main tools.

• Mindfulness: Mindfulness skills teach you to stay in the present moment and concentrate on your current circumstances.
• Emotion Regulation: Learn to change, accept and manage your emotions so that they do not control you.
• Distress Tolerance: It helps to learn to tolerate painful emotions and unbearable situations and avoid behavior that can worsen things.
• Interpersonal Effectiveness: Learn to communicate respectfully with others while maintaining healthy boundaries and positive self-esteem.

Eye Movement Desensitization and Reprocessing

EMDR is a type of trauma therapy in which an outside stimulus, usually flashing lights or vibrating objects, alternately stimulates each side of the brain. Our brains' two hemispheres process information differently. One side is rational facts, and the other is feeling and emotions. 

A person can sometimes reprocess traumatic memories in a way that creates healing and new emotional-factual associations by alternately stimulating each side of the brain. Our brains and bodies can become less emotionally reactive in situations that trigger our anxiety by dealing with past trauma.

Talk Therapy

Talk therapy, or psychotherapy, communicates and works with a mental health professional through mental health conditions and circumstances. In simple words, talk therapy is a method of exploring one's feelings by talking about them. It takes many forms, including cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), psychodynamic therapy, and humanistic therapy. 

Talk therapy teaches you new and effective coping strategies for dealing with stress and its consequences. It can aid in the recovery from anxiety, depression, trauma, and other mental health symptoms, conditions, and issues.

Mindfulness And Meditation

Numerous resources are available to help you learn meditation and Mindfulness techniques, such as meditation teachers on YouTube, meditation apps, books, and audiobooks. We know to pause, tune into our breath, breathe deeply, calm the mind, and focus on our well-being through Mindfulness and meditation. 

Focusing on the breath intentionally helps to calm the central nervous system, bring us back into our bodies, and slow down our reactiveness. Guided meditations (via videos or apps) can be highly beneficial in learning Mindfulness and meditation.

Side Effects Of Non-Addictive Anxiety Medicines

The non-addictive anxiety medication's side effects usually fade after three to four weeks. However, if the side effects persist or any adverse reactions occur, contact your mental health professional immediately.

Anxiety Medications Interactive Medications

Interactions can affect how a drug works in your body, with another medication causing serious side effects. Drug interaction can be mild, moderate, or severe.

• Concurrent use of SSRIs or SNRIs with MAOIs raises the risk of serotonin syndrome.
• Starting Escitalopram in a patient taking linezolid or IV methylene blue is not recommended due to an increased risk of serotonin syndrome.
• When combined with SSRIs or SSNRIs, aspirin can increase the risk of bleeding.
• When Pregabalin is combined with other medications that cause drowsiness or breathing difficulties, serious side effects such as slow/shallow breathing and severe drowsiness/dizziness may occur.
• The combination of an opioid and hydroxyzine may increase the likelihood of drowsiness.
• Use of Hydroxyzine with drugs that prolong the QT interval- Quinidine, Procainamide, or
• Amiodarone- can cause serious side effects such as shortness of breath, palpitations, and irregular heart rhythms.
• Concurrent Beta-blocker and antidepressant administration with moderate to strong CYP2D6 interaction can result in severe hemodynamic events.

Bottom Line From Practical Anxiety Solutions

Anxiety is frustrating and sometimes creepy. Fortunately, there is extensive assistance available. Non-addictive anxiety medication, therapy, or both may be best for you. 
Non-addictive anxiety medication aids in the management and reduction of anxiety symptoms.

Though it has some side effects, Common ones will disappear after a few weeks. Any medicine, however, should only be taken with the prescription and strict supervision of a licensed medical expert.

When possible, it is always preferable to use non-pharmacological treatment for anxiety. Even when people require medication, incorporating alternative anxiety treatments can help improve treatment outcomes.