Prescription and over-the-counter anxiety meds: What's the difference?

Medically reviewed by Andrea Brant
Updated January 8, 2024by BetterHelp Editorial Team

Note: This article mentions prescription medication and over-the-counter anxiety treatments. The information below is not a substitute for professional medical advice. Seek a medical doctor's advice to start, change, or stop a medication, including over-the-counter options. 

Over-the-counter (OTC) anxiety medications may appeal to some, as they can be picked up at a pharmacy without a prescription. In addition, they may cost less than prescription options without insurance. For this reason, some people may wonder whether OTC medications or prescriptions are best for treating anxiety. It can be helpful to understand the anxiety medications available before you discuss your options with your doctor to make an informed decision. 

Is anxiety affecting your life?

What types of anxiety meds are available?

Anxiety is one of the leading mental illnesses among children and adults worldwide, affecting over 40 million adults in the US. For that reason, many treatments have been developed to address the condition, including different forms of medication. Below are some of the most common anxiety medication options. 

Herbal anxiety remedies

Some herbs may work as natural anxiety remedies, but only two have been proven effective by studies and trials: St John's Wort and Kava. These plants have natural substances within their leaves, roots, flowers, fruits, or bark that can interact with the nervous system to decrease anxiety symptoms.

Herbal remedies can come in several forms. You can purchase them in capsules or drink them as herbal tea. Tinctures are another option and are made by dissolving the herb in alcohol. You can purchase these remedies online or through an herbalist at local stores.

Some of the most used herbs for anxiety include:

  • Valerian root
  • St. John's wort 
  • Kava kava
  • Ashwagandha
  • Rhodiola
  • Lavender
  • Passionflower
  • Chamomile
  • Lemon balm
  • Holy basil
  • Green tea

Homeopathic remedies 

Like herbal remedies, homeopathic medicine for anxiety is natural. Homeopathy is a natural treatment widely used in many parts of the world, though it's sometimes less practiced in the United States. Remedies chosen in homeopathic medicine are meant to facilitate the body's healing processes.

Some of the homeopathic remedies used for anxiety include:

  • Aconite
  • Argentum nitricum
  • Arsenicum album
  • Calcarea carbonica
  • Gelsemium
  • Ignatia
  • Kali arsenicosum
  • Kali phophoricum
  • Lycopodium
  • Stramonium

While these remedies can be found online, they may not offer results. The scientific community largely denounces homeopathy as a pseudoscience, and more research must be done before conclusions are made on effectiveness. 

Over-the-counter treatments

OTC medications are Western medications you can get in a pharmacy without a prescription. These medications may be designed for other purposes but can also have properties or side effects that may reduce anxiety. However, it can be essential to note that OTC meds have not been approved for use as anxiety medications and may cause side effects. 

Common OTC medications used for anxiety are anti-allergy medications. The calming effects of the medication can be mild but may provide fast-acting relief. However, one common side effect is extreme sleepiness, which can cause one to sleep throughout the day and night. 

Individuals wanting to reduce nervousness may use other medications that cause sedation, including other anti-allergy meds, cold medicines, cough syrups, sleep medications, and painkillers. Although these medications may provide a brief respite, they can cause dangerous side effects when not used as recommended. Consult a medical doctor before trying any remedy for your anxiety. 

A medication sold over the counter doesn't mean it is safe. OTC medications can interact with regular medications, vitamins, supplements, food, and substances. Mixing the wrong medications without a doctor's advice can cause unwanted symptoms or illness.  

Prescription medications 

Prescription medications are often the recommended medical solution for moderate to severe anxiety. If you seek support from a physician or psychiatrist, they may suggest a prescription anxiety medication.

A few types of anti-anxiety medication categories include the following: 

  • Anxiolytics 
  • Antidepressants 
  • Beta-blockers 

The above medications have been approved specifically to treat anxiety disorders. However, seek help from a doctor before starting or stopping any medication.

Because any anxiety medication has the potential for misuse, taking it without a doctor's guidance can be dangerous. These medications may need to be adjusted over an extended period to avoid the chance of side effects. When you take more than prescribed, it could result in severe health consequences. In addition, stopping medication without tapering off could lead to withdrawal symptoms. 

What are the disadvantages of OTC treatments for anxiety? 

Over-the-counter anxiety meds may seem like an easy fix for troublesome symptoms. However, there are a few reasons to be cautious of or avoid OTC meds. Natural and herbal remedies are not controlled in the same way as medication. You won't necessarily know how much you're getting or what the quality is. In addition, there may not be extensive research on natural anxiety remedies to understand their effectiveness.

Specific herbal remedies can carry serious risks. For example, kava has been banned in some countries because it may pose a risk of liver damage. When you take anti-anxiety over-the-counter meds without supervision, you can't know how they'll interact with each other or your other medications. 

When self-medicating, some people may take more than is recommended on an OTC medication. For example, they may take multiple anti-allergy medications to strengthen their impact. However, taking more than the dose recommended on an OTC package can be dangerous and lead to serious side effects. OTC medications are still medications, so discuss these options with your doctor. 

How to avoid the disadvantages of anti-anxiety medications 

Regardless of the remedy or medication you want to try, ask your doctor beforehand. In addition, report any side effects or unusual symptoms that start after consuming them. Do not take OTC medications unless your doctor has approved them for use. 

Taking prescription medications as prescribed by a doctor can offer several advantages not present with OTC medications. For example, your doctor can be there to track your progress and watch for side effects. They can also determine the correct dose and track how it's working and affecting you. If you decide to stop taking medication, your doctor can counsel you safely. 

Below are a few ways to help your doctor in this process: 

  • Keep a written record of symptoms and side effects
  • Openly tell your doctor about any OTC meds or supplements you're taking
  • Keep a list of the anxiety medications you're taking to bring to appointments 
  • Take medications only as your doctor tells you to 
  • Don't stop taking a medication without your doctor's advice and approval 
  • Build a healthy lifestyle
  • Prepare for the possibility of no longer taking the medications in the future 

Is anxiety affecting your life?

The role of therapy in anxiety treatment

Taking medications for anxiety can reduce symptoms in the short term. However, your anxiety may increase over time if other treatment options are not considered. One recommended treatment option is therapy, which can effectively treat anxiety disorders. 

A technique known as cognitive-behavioral therapy (CBT) has been proven to work especially well for anxiety. According to a team of anxiety scientists led by Dr. Borwin Bandelow, "The efficacy of CBT for all anxiety disorders has been shown in a large number of controlled studies." For those who face barriers to in-person CBT, other studies have proven that online CBT is as effective as in-person CBT in treating anxiety symptoms.

With the availability of online counseling platforms like BetterHelp, seeking treatment for anxiety can be more reachable, cost-effective, and flexible. You can get treatment from home or anywhere you have an internet connection. In addition, you can schedule your session according to your weekly demands and choose between phone, video, or live chat session formats. 

Takeaway

Medication for anxiety is sometimes beneficial but should be taken with the supervision and approval of a medical professional. In addition, it may be most effective when used in conjunction with therapy. If you're ready to talk to a therapist about anxiety treatment, consider contacting a provider online or in your area for further guidance and support.
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