Anxiety medications are controlled substances for a reason. It all comes down to anxiety’s action within the brain.
Chronic anxiety (and panic attacks) can influence your central nervous system, causing your brain to release stress hormones such as adrenaline and cortisol more frequently than normal. This can result in various symptoms of anxiety, including depression, headaches, and dizziness.
Adrenaline and cortisol are extremely helpful when you’re in a threatening situation - they’re an essential component of your body’s fight-or-flight response, the reaction you have when exposed to dangerous situations. However, when you are responding to imagined threats (as is common with anxiety disorders), your brain is continually releasing stress hormones unnecessarily.
Therefore, to treat anxiety, treatment methods need to focus on preventing this neurological reaction. And anything powerful enough to affect the brain in this way you should only use after professional medical advice from a doctor.
And it’s important to ask yourself, “would I want over-the-counter medication for my anxiety?” Anxiety is not a disease that can be cured by taking some medication for a week. Instead, it’s a condition affecting the way you think and feel.
Medication dulls anxiety but it doesn't cure it. You'd have to take medication for the rest of your life, and that can lead to difficulties such as dependency, side effects, and a reduction in effectiveness over time. It may also prevent you from seeking further methods that could reduce your anxiety.
To truly combat anxiety, you need to understand why you’re anxious in the first place. You may need to speak to a mental health professional such as a therapist for this - more on that topic later!
Still, medications can help with the emotional distress and physical symptoms anxiety causes. So, why are there no over-the-counter treatment options?
Reason #1 Potential for Abuse
Taken in certain ways, anti-anxiety medications can cause significant mental impairment, and the concern is that if they were available over the counter, many people would be taking these drugs off-label. That's too dangerous.
Remember, these are drugs that affect your brain directly. They alter your body's production and reception of neurotransmitters. That can be useful for reducing anxiety but can cause significant side effects and be extremely dangerous if more is taken than directed. They also interact with numerous other medications, alcohol, and more. These medications simply cannot be sold over the counter without posing a significant risk to the community.
Reason #2 Side Effects
Even over-the-counter medications can elicit harmful side effects. And, without a doctor’s supervision, this could have serious repercussions. One example of this is Benadryl.
In the past, many people have used Benadryl to manage their anxiety symptoms because it’s fast-acting and convenient - taking just 15 - 30 minutes to kick in and lasting for several hours. Yes, it reduces anxiety symptoms temporarily, but Benadryl was never intended for long-term use. It comes with various side effects, including:
And these are just the most commonly reported. Other, more severe side effects, include:
- Lower red blood cell levels
- Irregular heart rhythm
- Rapid heartbeat
- Memory loss
With other medications, you may suffer from a decreased appetite, weight loss, and other adverse effects impacting your health. Without the assistance of a doctor, these side effects may be deadly. These can be particularly troublesome if you’re in a vulnerable group, such as pregnant women, the elderly, and young children.
Reason #3 Hands-Off Approach
In the short term, these medicines may provide some relief. But unfortunately, if you use these medicines for so long without any additional coping tips, your brain will start to depend on them as the only way to cope with stress.
As anxiety symptoms ease, you may feel a natural pull away from coping mechanisms you previously used to reduce your anxiety, reading to dependence on over-the-counter medication as your sole treatment approach.
So when you stop taking these medicines, you'll have lost some of your natural coping skills which, if you suffer from anxiety, may already have been struggling with. That's a significant risk without alternative treatments and a doctor's supervision.
Will Anxiety Medications Ever Be Available Over the Counter?
There may be a day when an over-the-counter anxiety medication is a viable option. Some medications, like Buspirone, are less powerful (while still useful for mild anxiety) and have fewer side effects.
It is possible that a medication like Buspirone may someday be released with a primary focus on easing anxiety symptoms, but given that it can also take several days for the medications to start working, and they are not as powerful as benzodiazepines and other prescription medications, it still may not be the right choice.
Someday there will be an over-the-counter anxiety medicine, but as of yet, there are no medications that meet the criteria that would make them viable as an over-the-counter option.
Alternatives to Over-the-Counter (OTC) Anxiety Medications
Until OTC medications become available, there are several effective alternatives that you could try. Let’s look at each option in turn.
Talk therapy has proven a highly effective method for managing anxiety symptoms. One of the most common forms of therapy for anxiety disorders is Cognitive Behavioral Therapy (CBT).
In CBT, you work with a therapist to identify the factors contributing to your anxiety, focusing on problem-solving rather than digging deep into the past, unlike other therapy approaches such as psychodynamic and humanistic.
Researchers extensively study the benefits of exercise on mental health and well-being. One of the positive effects of regular exercise is that it reduces anxiety. It does this in several ways:
Exercise provides a welcome distraction from anxious thoughts and the physical symptoms associated with chronic anxiety.
Reduces Muscle Tension
Exercise gets your muscles active, which can help to reduce muscle tension and other anxiety effects on your muscles.
Increases Heart Rate
Exercise makes your heart beat faster, which alters your brain chemistry, encouraging the release of anxiolytic (anxiety-reducing) neurochemicals such as GABA, serotonin, and BDNF.
Activates Specific Brain Regions
Your frontal brain regions are activated when you exercise. These areas are responsible for executive function, enhancing control over the amygdala, an area of the brain related to the stress response.
There are also several herbal ingredients that reduce anxiety. This includes:
- Kava. Kava is an herbal supplement that some studies have shown may be as effective as several anxiety medications. Kava should still be used under the supervision of a doctor since it can interact with other medicines and alcohol, but as it is an herb that is available without a prescription, it may be worth trying. Passionflower and valerian may also be beneficial, although they are not believed to be as powerful.
- CBD oil. CBD oil is an extract of the cannabis plant (known as Cannabidiol). It is usually taken from industrial hemp, which contains very little THC (the drug that causes the high), and even then any remaining THC is completely removed. Although we cannot recommend CBD oil yet due to a lack of research and questionable legality, there are studies showing that this extract may have stress relief benefits. Talk to your doctor about the risks and benefits of CBD.
- 5-HTP, L-Tryptophan, or Sam-e. Although many neurotransmitter imbalances have been linked to anxiety, serotonin is the one that has the strongest connection for most people. In theory, increasing serotonin levels in the brain should be able to decrease anxiety symptoms. According to natural health promoters, 5-HTP, L-Tryptophan, and Sam-e are three supplements that increase serotonin levels. It is not clear that they work in the research, but they are available over the counter for those interested in trying it.
- Water and Magnesium. In some cases, anxiety may be caused or exacerbated by a lack of important nutrients. So drinking a lot of water and taking magnesium supplements may help some people reduce their anxiety and find some degree of relief, even if it doesn't cure the anxiety altogether.
To learn more, read our article on natural remedies for anxiety.
None of these are guaranteed immediate cures, but they can be a tremendous help. If you're someone that benefits from relaxation exercises like deep breathing, progressive muscle relaxation, and visualization, then you should try those as well.
You should never self-medicate with alcohol, or with any drug not designed for anxiety. Self-medication has the same effect as anxiety medicines - use them when you're feeling anxious, and you start to depend on them and lose your ability to cope any other way.
Next Steps for Anxiety
Anxiety isn’t a quick fix. You need to work on it regularly and learn the skills necessary to reduce anxiety, as well as figure out the cause of your anxiety in the first place.
While many consider taking medication a short-term solution, it can often turn into a long-term problem, especially if consumption isn’t supervised by a doctor.
However, there are some approaches you can take to manage anxiety yourself, such as talking therapy, exercise, and herbal remedies. But be sure to speak to your healthcare provider to identify the best course of action for you.
There are no OTC medications for anxiety since any medication that affects the brain needs to be carefully monitored; that’s why they tend to be prescription medication only.
Medication is not the only treatment a person should take as it can lead to dependency, unpleasant side effects, and reliance as the only coping strategy.
Luckily, there are other natural remedies for treating anxiety, including talk therapy, exercise, and herbal products. Ultimately, more research is needed to uncover a truly effective over-the-counter medication for anxiety.