How Effective are SSRIs for Anxiety?

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  • Edited By: O. Wallace
  • Last Modified Date: 30 September 2019
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Some studies have shown that selected serotonin reuptake inhibitors (SSRIs) don't always work when they're used to treat depression, leaving many questioning their effectiveness. In many cases, people who have one of the anxiety disorders, like generalized anxiety, panic disorder, post traumatic stress, social anxiety, obsessive-compulsive disorder, or specific phobias are treated with an SSRI. This might be used in conjunction with other medications, such as benzodiazepines, and they definitely need to be used with ongoing behavioral or talk therapy to address the underlying condition. Usually, SSRIs don’t work without therapy and they may be less effective if the anxiety condition is relatively mild or occurs infrequently.

The medical community has long posited a connection between depression and anxiety disorders. They believe both are related to too little free serotonin in the brain. An SSRI binds to serotonin receptors and thus keeps serotonin from being used too quickly. The extra serotonin can then be used to balance mood, whether anxious or depressed. This is a highly theoretical explanation, since it’s impossible to measure this neurotransmitter, and additionally, very little of it is in the brain. Most of it is manufactured in the gut.


When physicians follow this theory, it makes sense to prescribe similar medicines for depression and anxiety conditions. If serotonin creates mood balance, SSRIs for anxiety are perhaps the best choice. Only it turns out that some SSRIs are better at treating anxiety than others. Physicians believe that the drugs Prozac®, Paxil®, Zoloft®, Lexapro® and Celexa® may be of benefit. A related group of drugs called the serotonin norepinephrine reuptake inhibitors (SNRIs) are also prescribed, and of these the most popular may be Effexor® or its newer version, Pristiq®.

There is also evidence when considering which SSRIs for anxiety are most appropriate that support the belief that some may be better at addressing specific anxiety disorders. For example, Luvox® may be slightly better at treating obsessive-compulsive disorder than most other SSRIs. Paxil® is considered more effective to treat social anxiety. What is thought true on the large scale doesn’t necessarily apply to the individual, and it is sometimes necessary to try several different medications before finding one that works the best.

The best-working drug may or may not be an SSRI; it could be an SNRI, an anxiolytic like Buspar®, or a drug from the tricyclic or monoamine oxidase inhibitor classes of antidepressants. Alternately, sometimes a short-acting drug like a benzodiazepine is either the best first choice or is used in conjunction with an SSRI. For example, if people have fear of flying, it might not be necessary to take daily medicine, unless a patient is a pilot or flight attendant. Short acting benzodiazepines for the few times a year when a patient flies is a better idea than SSRIs for anxiety.

For best results, the medication is combined with different forms of therapy. Most people may be able to shed an anxiety condition if they work with a psychotherapist, too. Recommended treatment for anxiety conditions includes medication and therapeutic care.


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Post 2

It's never appropriate to say that any medication is always evil for every person, based on your experience. I'm sorry that you didn't have a good experience with SSRIs, but that doesn't mean that nobody does.

I've taken an SSRI for 10 years. It's given me a life. I suffer from extremely severe and disabling panic and anxiety that is greatly relieved by the medication. I am grateful for it.

I've quit the drug twice and you're right that withdrawing should be done on a taper, not "cold turkey." Tapering off, when done correctly, need not be hell on earth. It can be totally manageable and non-traumatic.

These words come from someone who has experienced it all firsthand. Every person must balance the risks and benefits of every drug for themselves.

Post 1

SSRIs and SSRIs are not your friend. Your doctor/psychiatrist is lying to you. They told me all the same stuff they tell you: non addictive, barely any side effects, no long term issues.

In reality. you will find they are 100 percent addictive, complete with withdrawal, a list of side effects ranging from worsening of depression, suicidal thoughts, and loss of libido (like non-existent).

Finally, when you have a moment of clarity and realize your life is suffering more from the medication than without, you will have to "come off" the meds, experiencing some of the most uncomfortable withdrawal out there.

Do not let your doctor take you off these meds without tapering or "weaning" off. Failure to heed this warning will result in you experiencing hell on earth. These words come from someone who has experienced it all firsthand.

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