Treatment types
Medications for GAD act on the nerve cells in your brain, although the precise way in which they work differs. They alter the amount of the chemicals in the brain that influence how we feel.
The first medication your doctor will give you is an SSRI (selective serotonin reuptake inhibitor). If that particular SSRI is not effective, then your doctor may give you another SSRI or an SNRI (serotonin-norepinephrine reuptake inhibitor), but the choice of one or the other depends on a number of factors. In some people, neither a SSRI or SNRI will be suitable and the doctor may give you pregabalin. Occasionally, the symptoms of GAD may be very severe and benzodiazepines may be given for a few weeks.
If it turns out that one medication doesn’t work for you, don’t give up. All you need to do is discuss other options with your doctor.
Click on each of the medications below to find out more about them. If your doctor prescribes a medication, it is important to remember that everyone is different and will respond to these treatments in different ways.
Selective Serotonin Reuptake Inhibitors (SSRIs)
These are the first-line medication for GAD. SSRIs improve the symptoms of GAD by increasing the levels of the chemical serotonin in your brain. Serotonin plays a vital role in how different parts of the brain communicate with each other, and it helps regulate our moods and feelings of wellbeing.
SSRIs can take around three weeks to start working. Even if your symptoms improve your doctor may recommend you continue with the treatment for several months.
One big problem with SSRIs is what’s known as the ‘withdrawal syndrome’, which can occur if stop taking the medication suddenly. For this reason, if you’re taking a SSRI and you feel like stopping you must talk to your doctor first. Common side effects of SSRIs include: feeling sick, low sex drive, diarrhoea or constipation, dizziness, loss of appetite and insomnia.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
The second-line medication for GAD. SNRIs act in a very similar way to SSRIs, increasing the levels of serotonin and another brain chemical called norepinephrine.
Like SSRIs there is a risk of a withdrawal syndrome, so you shouldn’t stop taking a SNRI without talking to your doctor first. People with heart problems or high blood pressure should not take SNRIs. Common side effects include: sickness, drowsiness, dizziness, dry mouth, constipation, indigestion and insomnia.
Pregabalin
Pregabalin is quite a new treatment option for GAD – recommended as third-line therapy. Unlike SSRIs and SNRIs, it does not increase serotonin levels, but acts on other brain chemicals.
If you stop taking this medication suddenly you can develop withdrawal symptoms, so always talk to your doctor first if you’re thinking about stopping. The most commonly reported side effects are drowsiness, dizziness and headaches.
Benzodiazepines
Rarely used and for no longer than four weeks if someone has very severe GAD symptoms. They start working very rapidly – within 30-90 minutes of being taken. Common side effects include: confusion, loss of balance, memory loss, drowsiness and light-headedness.
Buspirone
Buspirone is a medicine that may be used as a short term treatment for GAD. You would normally take a Buspirone for a couple of weeks before you would notice an improvement. Common side effects include: dizziness, headache, light headedness and sleep disturbance.
Antihistamines
Antihistamines are commonly used to treat allergic reactions. However some, for example hydroxyzine may be used to treat anxiety on a short term basis. Common side effects of hydroxyzine include: dizziness, blurred vision, headache and dry mouth.