A Guide to Over-the-Counter Anxiety Medication | E-Counseling.com

A Guide to Over-the-Counter Anxiety Medication

MS Broudy Ph.D
November 19, 2020
Over-the-Counter Anxiety Medication

Anxiety is one of the most common mental health problems in the United States. It is estimated that 31.1% of American adults experience an anxiety disorder at some point during their lives. The most common medical treatment for anxiety is prescription medication. SSRIs and benzodiazepines, among others, are effective but they exhibit numerous side effects and can become habit-forming. Besides, many people just don’t feel comfortable taking prescription drugs. Here are some over-the-counter alternatives and why you may want to consider them.

Types of Over-the-Counter Medications

Antihistamines

Several over-the-counter alternatives to the highly effective (and addictive) benzodiazepines possess sedative properties. Antihistamines that contain the active ingredient diphenhydramine, such as Benadryl, can be used for a calming and drowsiness effect. Vistaril (hydroxyzine) is another antihistamine that works similarly. You are going to see several treatments in this article that are sedatives. That is because when you are calm and sleepy you aren’t anxious.

These medications, however, were not created to help with anxiety. They are allergy medications and have not been approved for continual use by anxiety sufferers. Further, because they cause drowsiness, people must be cautious about their use during non-sleeping hours.

Herbal Treatments

Many people swear by herbal treatments to help reduce anxiety. Regrettably, they have not been heavily studied for use as anti-anxiety treatments. In addition, they generally do not work as well as prescription drugs. Here are herbal medicines that have been associated with decreased anxiety:

Valerian

Much like Benadryl, Valerian has a sedative effect. It is often recommended as a sleep aid. It is noted to have a peculiar smell so many people prefer to take it in capsule form. Depending on the study, it has been found to have a significant effect on anxiety or none at all. Side effects including headaches, dizziness, and drowsiness are possible.

Chamomile

Have you ever had anyone suggest chamomile tea to settle your nerves? Chamomile has long been associated with a calming effect. Research, however, has exhibited largely inconclusive results. Be aware: it can increase the risk of bleeding when using certain blood thinners. It can also cause reactions in people that are allergic to related plants, such as ragweed.

Passionflower

The support for passionflower as an anti-anxiety agent appears to be growing. Although it may not have as large an effect as some other over-the-counter options, there is some evidence of its effectiveness for the treatment of generalized anxiety. It is also generally safe and it does not make you sleepy. As a result, it is approved for use with other treatments that may cause drowsiness.

Green Tea

Green tea has a reputation for being good for you. But did you know it has anti-anxiety properties? L-theanine is an amino acid found in green tea that has been associated with anxiety reduction. And it is relatively safe. The problem for tea lovers is that you need to drink at least five cups to get a significant anti-anxiety effect. Make sure you are near a bathroom.

Lavender

Aromatherapy has a lot of fans and many of them find lavender relaxing. It has considerable anecdotal support as a calming agent. It is not surprising to find the smell of lavender used in spas and massage parlors to set the appropriate mood. Lavender does show evidence in decreasing anxiety, but only if you take it orally. Its use in aromatherapy, sadly, does not share the same empirical support.

Kava

Of all the herbal supplements, Kava is probably the most researched in relation to anxiety. There have been numerous studies indicating its effectiveness, especially with generalized anxiety. Unfortunately, the use of Kava has been linked with liver toxicity. Although it may be the most effective herbal supplement, it also carries the most serious risk.

Vitamins and Supplements

Antihistamines and herbal products make up the majority of over-the-counter anxiety medications but there are other options that you may want to consider:

Melatonin

Melatonin has long been recommended as a natural sleep aid. Not surprisingly, that sedative quality also makes it attractive for anxiety sufferers. It has been used effectively to treat preoperative anxiety as a replacement for benzodiazepines. One of its most advantageous qualities is that it has been used extensively without the report of significant side effects.

Inositol

Inositol is a carbohydrate that is linked with serotonin production. Serotonin levels have long been implicated in the development of depression and anxiety. Although the research is not entirely conclusive, inositol has shown promise in reducing panic attacks and agoraphobia.

Magnesium

Magnesium appears to play a role in the part of the brain related to stress and anxiety. Deficiencies in the mineral are associated with increased anxiety. In order to put more magnesium in your diet, you can ingest it naturally through certain foods, including spinach, avocado, and nuts. If those choices do not appeal to you, it also comes in supplements.

5-Hydroxytryptophan (5-HTP)

5-HTP is an amino acid necessary for the production of serotonin in the brain. Similar to inositol, it is thought that an increase in 5-HTP will reduce anxiety. Research, however, is somewhat inconclusive. While some studies show anxiety reduction, others point to 5-HTP making anxiety worse.

Tylenol

You take Tylenol for physical pain so why not emotional distress? Interestingly enough, it has been found to dull stressful feelings in the same way it masks physical aches. Tylenol contains acetaminophen, which appears to act as an anti-anxiety agent, alleviating social anxiety and worries about death. Unfortunately, the ingredients in other pain relievers (e.g., Ibuprofen) do not appear to have the same anxiety-reducing effects.

Over-the-Counter Anxiety Medications Safe?

Many people hear the words herbal, vitamins, and natural and think they are automatically safe. Sadly, that is far from true. Most of the over-the-counter options for anxiety are unregulated by any government agency. As a result, it is unclear how herbal remedies and supplements impact people at certain dosages and lengths of administration. It is generally thought that the side effects of over-the-counter medications are less severe but most have not been extensively tested for long-term use.

While these treatments are undoubtedly less addictive than benzodiazepines, they can still be subject to abuse. Any substance that acts as a way to escape anxiety and depression can be habit-forming.

Do Over-the-Counter Anxiety Medications Work?

This is probably the number one question about non-prescription treatments. And the evidence is mixed. While some studies support every medicine on this list as an anxiety reducer, others exhibit contradictory or insignificant findings. A lot of the studies involving over-the-counter medicines are done with small samples and poor research designs. Besides antihistamines, the effectiveness of almost every over-the-counter medicine for anxiety can be debated.

Caution About Anxiety Medication

Anxiety needs to be consistently confronted if you are going to manage it successfully. Medication, by its very nature, serves more as a way to overcome the symptoms. Therefore, it may help in the present but it will not cure long-term anxiety. 

Psychotherapy, on the other hand, will help you to learn strategies and resolve issues that can lessen anxiety for the rest of your life. That being said, medication might be able to give you the boost you need to confront your anxiety. It is especially necessary if you are having difficulty with everyday functioning. Once you are feeling healthier and more in control of your life, however, you may want to speak with your doctor about gradually scaling back on medicine and focus more on developing your coping skills.

Substances to Avoid

When considering what you may want to put into your body, there are some substances you should avoid. Caffeine, sugar, and excessive alcohol use can all worsen anxiety.

  • Caffeine is a stimulant. It makes you feel jittery and mimics anxiety symptoms. It can even trigger a panic attack.
  • You may feel like alcohol makes you less anxious but it can be just the opposite. There is a condition called substance-induced anxiety disorder, which can be provoked by alcohol and caffeine. In addition, some people use alcohol to escape from anxious feelings which only makes it worse when the effects wear off.
  • Eating sugar causes spikes in our blood sugar which may prompt anxiety and mood swings. Further, one study exhibits how sugar actually decreases our ability to deal with stress.

The moral of the story for anxiety sufferers: alcohol, caffeine, and sugar should only be consumed in moderation or not at all. A healthy well-balanced diet is recommended to help with anxiety symptoms.

The Bottom Line on Over-the-Counter Options

The biggest advantage of over-the-counter medicines is that they are easy to obtain and use. Walk into most drug stores and a few minutes later you will likely have what you want. They also tend to be less addictive and appear to have fewer side effects than traditional anxiety medication.

However, due to a lack of research, many of the effects of long-term use are unknown. The biggest disadvantage is they don’t appear to be as effective as prescription drugs. If you have decided that you need to take something for anxiety, and prescription medication is not for you, over-the-counter medicines may be worth a try. Do yourself a favor, though, and combine it with psychotherapy for lasting change.

MS Broudy Ph.D

MS Broudy is a psychologist, writer, and consultant. He has a Ph.D. in Clinical Psychology and a master’s degree in Social Psychology. He has spent over 20 years providing therapy and assessment services for a diverse set of clients. MS specializes in writing about mental health, parenting, and wellness. He has his own blog, mentalspokes.com, where he writes about psychological issues.

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