Several effective options exist for managing anxiety, ranging from prescription medications to supplements you can buy over the counter. What works best depends on whether you’re dealing with ongoing generalized anxiety, occasional panic, or situational stress like public speaking. Most people with moderate to severe anxiety benefit from a combination of medication and therapy, but milder cases often respond well to lifestyle changes and targeted supplements.
SSRIs and SNRIs: The Most Common Starting Point
If you visit a doctor for anxiety, you’ll most likely be prescribed a medication that increases serotonin activity in your brain. These drugs, called SSRIs, work by preventing your brain from reabsorbing serotonin too quickly, which keeps more of it available to regulate your mood. The two most commonly prescribed for anxiety are sertraline (Zoloft) and escitalopram (Lexapro). Sertraline typically starts at 25 mg per day and can go up to 200 mg, while escitalopram starts at 5 to 10 mg and can reach 30 mg.
A related class called SNRIs does the same thing with serotonin but also boosts norepinephrine, another brain chemical involved in mood and alertness. Venlafaxine (Effexor XR) is the most commonly prescribed SNRI for anxiety, starting at 37.5 mg per day with a target range of 75 to 300 mg.
The biggest thing to know about these medications: they don’t work immediately. Most people need four to six weeks before feeling the full effect, and the first week or two can actually make anxiety temporarily worse. This is normal. You also can’t stop them abruptly. Quitting suddenly can cause discontinuation syndrome, with symptoms like dizziness, flu-like achiness, nausea, burning or shock-like sensations, and ironically, a rebound in anxiety and irritability. Tapering off safely is a gradual process that your prescriber will guide you through.
Buspirone: A Non-Sedating Prescription Alternative
Buspirone is a prescription medication specifically designed for generalized anxiety disorder. Unlike the medications above, it doesn’t affect serotonin reuptake in the same way, and unlike the fast-acting options below, it’s not sedating or habit-forming. The tradeoff is patience: buspirone requires a multi-week or even multi-month trial before you can fairly judge whether it’s working. It’s often prescribed alongside an SSRI during that initial waiting period, or as a standalone option for people who can’t tolerate SSRIs.
Benzodiazepines: Fast but Risky
Benzodiazepines like alprazolam (Xanax) and lorazepam (Ativan) are the fastest-acting prescription option for anxiety. They calm your nervous system within minutes, which makes them effective for panic attacks and acute anxiety episodes. Some are short-acting and wear off in a few hours, while others last much longer.
The problem is dependence. These medications are controlled substances because they can be habit-forming even when taken exactly as prescribed. Long-term use carries a real risk of developing a use disorder, and withdrawal can be dangerous. Most prescribers now treat benzodiazepines as a short-term bridge rather than an ongoing solution, using them sparingly while waiting for an SSRI or therapy to take effect.
Beta-Blockers for Performance Anxiety
If your anxiety is situational (presentations, interviews, flying), a beta-blocker like propranolol may be more appropriate than a daily medication. Propranolol doesn’t change your brain chemistry or mood. Instead, it blocks the physical symptoms of anxiety: the racing heart, shaky hands, and sweating that make stressful situations feel worse. A typical dose for anxiety is 40 mg. It’s not habit-forming and doesn’t cause sedation, which makes it a practical tool for specific high-stress moments.
Ashwagandha: The Best-Studied Herbal Option
Among supplements, ashwagandha has the strongest clinical evidence for reducing anxiety. Multiple trials have found that it significantly lowers both subjective stress and anxiety scores and measurable cortisol levels (your body’s primary stress hormone) compared to placebo. Benefits appear to be greater at doses of 500 to 600 mg per day of root extract, though studies have used doses ranging from 240 mg to over 1,000 mg daily.
An international task force created by the World Federation of Societies of Biological Psychiatry and the Canadian Network for Mood and Anxiety Treatments has provisionally recommended 300 to 600 mg of ashwagandha root extract per day, standardized to 5% withanolides, for generalized anxiety disorder. One trial found that even a dose as low as 225 mg per day led to lower salivary cortisol levels compared to placebo after 30 days. These are meaningful results, though the effect is generally milder than what you’d get from prescription medication.
L-Theanine: Calm Without Drowsiness
L-theanine is an amino acid found naturally in green tea. At supplemental doses of 50 to 200 mg, it shifts your brain’s electrical activity toward alpha waves within about 40 minutes. Alpha waves are the pattern your brain produces during relaxed, alert states, like a calm focus rather than a drowsy fog. The effect is dose-dependent, with 200 mg producing the most significant increase, and it can last up to eight hours.
L-theanine won’t eliminate clinical anxiety, but it’s a useful tool for taking the edge off stressful days. It pairs well with caffeine (which is why green tea feels less jittery than coffee despite containing caffeine) and doesn’t cause dependence or withdrawal.
Chamomile: More Than a Bedtime Tea
Chamomile isn’t just folk medicine. In clinical trials, pharmaceutical-grade chamomile extract at 1,500 mg per day has been tested on people with moderate to severe generalized anxiety disorder over eight-week treatment periods, and it was well-tolerated with no severe side effects. Drinking chamomile tea delivers a much lower dose than the extract used in trials, so if you want to try chamomile seriously, a standardized supplement will get you closer to the amounts that have been studied.
Magnesium: Filling a Common Gap
Magnesium is widely marketed for relaxation and anxiety, though its effects haven’t been conclusively proven in human studies for those specific purposes. What is clear is that many people don’t get enough magnesium from their diet, and deficiency can worsen anxiety symptoms, muscle tension, and sleep problems. The recommended daily intake is 310 to 320 mg for adult women and 400 to 420 mg for adult men.
If you decide to supplement, magnesium glycinate is generally the best-tolerated form. Other types of magnesium commonly cause loose stools or diarrhea, while the glycinate form is gentler on your digestive system. Correcting a deficiency may help your baseline anxiety even if magnesium isn’t a direct anxiolytic.
Choosing What’s Right for You
Mild, situational anxiety often responds well to L-theanine, ashwagandha, or a beta-blocker before specific events. Moderate to severe anxiety that affects your daily functioning typically needs prescription medication, therapy, or both. Many people use a combination: an SSRI for baseline stability, a supplement like magnesium or ashwagandha for additional support, and cognitive behavioral therapy to build long-term coping skills.
What matters most is matching the intervention to the severity. Over-the-counter options are reasonable starting points for mild anxiety, but they’re not substitutes for evidence-based treatment when anxiety is significantly disrupting your work, relationships, or sleep.