Drugs & Medications

What Is The “Safest” Drug for Anxiety?

Micah Abraham, BSc

Written by

Micah Abraham, BSc

Last updated September 5, 2022

What Is The “Safest” Drug for Anxiety?

When it comes to treating anxiety, medications are popular with both doctors and patients. They work quickly and provide clear, medically reliable benefits. Some medications have side effects, some are expensive, and some are not meant for regular use, but medicine itself represents something that many people prefer: an immediate, rapid way to fight anxiety.

The problem is that some anti-anxiety medications are notorious for side effects, and while there may be some that are well tolerated, everyone may react to them differently. Below, we'll review the risks of choosing antidepressants and other anxiety medicines and then explain which medications are likely the "safest," depending on your perspective.

Safest Medications For Anxiety

The first thing to realize is that different anxiety disorders require different types of medications. So even if there is a "safest" anxiety medicine, the problem is that your own anxiety may not be helped by that specific medication. Furthermore, different levels of anxiety may require different types of medications.

It's important to remember that all medicines have a risk for side effects, especially medications that affect brain chemistry. In addition, everyone has different needs, different brains, and even different chemical imbalances that may lead to anxiety. That's why you should never take any medicine without your doctor's approval and supervision.

Finally, anxiety medications are not a cure. It is helpful to consider non-medicine treatments, like therapy and self-help, so that eventually you can wean off the medication.

What is a "Safe" Anxiety Medicine?

It's also difficult to discuss the safety of antidepressants for anxiety and other anxiety medicines because the word "safe" means different things to different people. The good thing about most anxiety medications is that none of them appear to have fatal side effects. All medications can have some exceedingly rare side effects that may not be known and allergies to medications can be very dangerous, but antidepressants, benzodiazepines, and others are highly unlikely to cause any severe or possibly fatal side effects. You can talk to your pharmacist if you're worried.

But anxiety medicines can cause two distinct types of side effects:

  • Physical
  • Psychological

Physical side effects are those that cause some discomforts that affect the body, rather than the mind. For example, a class of drugs known as Selective Serotonin Reuptake Inhibitors (SSRIs - a type of antidepressant) may cause:

  • Nausea
  • Sweating
  • Diarrhea/Constipation
  • Headaches
  • Dry Mouth
  • Weight Gain
  • Cloudy Thinking
  • Digestion Issues

These side effects may be disruptive enough to affect your well-being. Benzodiazepines may also cause digestion issues and nausea, and have other side effects that include:

  • Hypotension (low blood pressure)
  • Blurred Vision
  • Severe Fatigue/Impaired Driving Skills
  • Lack of Coordination
  • Seizures

In some cases, the side effects can be severe enough that the person needs to stop taking the medication right away. They also may cause dependency and withdrawal symptoms if you stop taking the medications, and in some cases, they may lose their effects over time as a result of tolerance.

Even though physical side effects appear to be common with anxiety medications, they may not be the most distressing. Some people find that the psychological side effects that cause them the most stressful issues. Unfortunately, it's impossible to know how the drugs will affect you unless you take them. Common side effects of these types of psychoactive medications include:

  • Paradoxical Effects In some cases, antidepressants and anti-anxiety medications can actually increase the symptoms of your anxiety disorder. It's unclear why, or who this effects, but many people find that their anxiety and depression increases while taking the drugs.
  • Personality Changes Many of these drugs can also lead to personality changes. In some cases, they may be emotional, like increased agitation. In others, it may simply be a change in how you act around others and what you enjoy.
  • Sexual Side Effects Many benzodiazepines and antidepressants cause a loss of libido. That loss of sex drive may lead to decreased energy for intercourse, the inability to get aroused, or problems with performance or perceived performance.
  • Cognitive Issues Because these drugs affect your brain chemistry, they may alter the way your mind works. You may have trouble remembering things, trouble concentrating, or trouble thinking quickly. It should be noted that that is not always a side effect. Sometimes the purpose of the drop is to clog anxious thinking. Benzodiazepines are designed to cause physical and mental fatigue so that you cannot feel as anxious. In others, they may be an unwanted side effect.
  • "Brain Zaps" and Other Issues Finally, some anxiety medications may cause you to feel symptoms that can best be described as unusual. For example, some cause what's known as "brain zaps" which make you feel like your mind is getting a jolt of electricity. Others may lead to your eyes feeling "nervy" or your movements feeling unusual. These symptoms are usually temporary and rarely dangerous, but they can make it harder to take these medications.

For some, physical side effects and fatality risk are the true sign of a drug's "safety." For others, it may be the way it affects you psychologically. What you’re willing to “risk” for a treatment makes a difference with how safe you find the treatment.

As we mentioned, because each person reacts differently to medications and has different views on what is considered a safe medicine, there is no truly “safe” option that can be considered safe for all people. There are many, however, that are quite well tolerated. Many popular anxiety medications are able to be taken without side effects (or with insignificant side effects) depending on how your body adjusts to it. As of this writing, some of the anxiety medications with the fewest reported side effects and least risk of side effects include:

  • Most Benzodiazepines (Xanax, Valium)
  • Bupropion (Wellbutrin)
  • Citalopram (Celexa - SSRI)
  • Paroxetine (Paxil - SSRI)

It is critical that this list comes with a caveat: the difference in side effect risk between these and other anti-anxiety medications is minimal for many of them, and each person both tolerates these medications differently and may require a different medication depending on the type of anxiety. Thus, the safest drug for you may not be any of the ones above.

However, since that answer is unlikely to please anyone, the safest anti-anxiety option is likely something weaker, like Buspirone (also known as Buspar). This type of medicine does cause brain zaps and some of the unusual "nervy" sensations but isn't likely to cause more severe anxiety or as much fatigue. Buspirone is was at one time considered as a possible over-the-counter anxiety medication but as of this writing still requires a prescription.

The problem with Buspar is that it tends to be too weak for many of those with anxiety and isn't considered helpful for panic disorder or depression. It's considered a mild generalized anxiety drug and may not be the right option for you.

Cure Anxiety - Don't Just Numb It

Medications are a great way to get some immediate relief for your anxiety. But it helps to remember that relying on medication alone can be problematic, simply because most of those with anxiety would like to eventually stop taking medications.

Doctors and psychologists all agree that medications alone simply aren't enough, and while they may be useful for temporary relief, they're not something that should be depended on for the rest of your life. For that, you need to make sure you commit to long-term, effective strategies for controlling anxiety.

Questions? Comments?

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Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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