Anxiety can be treated with medications, therapy and/or lifestyle changes , depending on your child's needs and their healthcare provider's recommendations. This page describes the medications that are most commonly prescribed to treat anxiety.
What type of medication is usually prescribed for anxiety?
If your child requires medication to treat anxiety, they will most likely be prescribed a class of medications called selective serotonin reuptake inhibitors (SSRIs).
SSRIs are especially useful when an anxiety disorder significantly disrupts a child's routine, for instance if the child refuses to go to school or has poor sleep patterns or a reduced appetite.
They are safer and have fewer side effects than other medications, but they must still be prescribed by a doctor.
Examples of SSRI medications include fluoxetine, fluvoxamine, sertraline, citalopram and escitalopram.
How SSRIs treat anxiety
SSRIs work by increasing levels of the chemical serotonin in the brain. This chemical controls feelings of general wellbeing and happiness. A person with anxiety or depression typically has lower levels of serotonin than someone without these disorders.
By working on the levels of serotonin, SSRIs may reduce physical symptoms of anxiety and other symptoms such as excessive worries or panic attacks. They can provide a faster and additional benefit to psychotherapy when treating anxiety disorders.
Most SSRIs come in pill or capsule form, but some come in a powder or liquid.
How long do SSRIs take to start working?
SSRIs typically take two to four weeks to start working. Sometimes, they can take up to six weeks. SSRIs generally need to be taken every day to be effective.
Before prescribing an SSRI, your child's doctor will discuss its benefits, risks and adverse effects with you and your child. They will monitor your child regularly, especially when your child starts the medication.
Some children and teens may find that SSRIs will make them feel worse before they feel better, but it is important to be patient and give the medication a chance to work.
Because people can have different responses to SSRIs, the doctor may need to try several different medications before achieving the desired effect. They may also need to increase the dose of an SSRI over time, as children and teens usually start on low doses.
How long might my child need to take an SSRI?
It is usually recommended that a person continue taking an SSRI until they are feeling well for six to 12 months.
What are the side effects of SSRIs?
Many people can take SSRI medications without any problems. However, some people may experience adverse side effects. Most of these effects, such as nausea, headaches, dizziness and restlessness, are mild and usually resolve within one to two weeks. For teens, other side effects may include lower interest in sexual activity and reduced sexual responsiveness.
Rare but serious side effects include an increase in suicidal thoughts. This can occur in up to 3 to 4 percent of teens treated with SSRIs and usually when treatment starts and ends. Another rare but serious side effect is an increased risk of bleeding.
Other medications to treat anxiety
Benzodiazepines
Benzodiazepines are central nervous system sedatives. This means they have a calming effect on many functions of the brain. They are sometimes used for short-term relief of anxiety symptoms, but they are not recommended for long-term use. Typically, they are not recommended for children and teens because of the risk of abuse and dependence.
Antipsychotics and other medications
In exceptional situations, a doctor may prescribe certain other medications, including antipsychotics, to treat anxiety disorders. These are considered only in special circumstances and their use must be monitored carefully by a psychiatrist.
Further information
For more information on anxiety disorders, please see the following pages:
Anxiety: Treatment with psychotherapy and lifestyle changes
Resources
The following resources offer useful advice and information about anxiety.
Books
Foa, E.B., & Wasmer Andrews, L. (2006). If Your Adolescent Has an Anxiety Disorder: An Essential Resource for Parents. New York, NY: Oxford University Press.
Huebner, D. (2005). What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety. Magination Press.
Manassis, K. (2015). Keys to Parenting Your Anxious Child. Third edition. New York, NY: Barron’s Educational Series, Inc.
Rapee, R., et al (2008). Helping Your Anxious Child: A Step-by-Step Guide for Parents. Second edition. Oakland, CA: New Harbinger Publications, Inc.
Sheedy Kurcinka, M. (2015). Raising Your Spirited Child: A Guide for Parents Whose Child is More Intense, Sensitive, Perceptive, Persistent, and Energetic. Third edition. New York, NY: HarperCollins Publishers.
Journal articles
Walkup, J.T. et al (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. New England Journal of Medicine. 359(26):2753-2766. doi: 10.1056/NEJMoa0804633.
