Treating Anxiety Without Controlled Substances

January 30, 2021

At one time, controlled substances such as Valium (diazepam) were the first thing physicians prescribed when dealing with complaints of anxiety. When it was found that patients often developed dependency and depression, newer types of treatment were developed.

Cognitive Behavioral Therapy (CBT) is a kind of talk therapy, or psychotherapy. The basic concept of talk therapy was invented by Dr. Sigmund Freud, still an icon of psychology and psychiatry. CBT is based upon the idea that emotions, thoughts, and behavior fit together into patterns that can be harmful or helpful. Patients talk out negative thoughts about themselves, or stressful situations, and discuss taking positive actions to break a pattern of poor coping and stress. Goals follow the SMART structure:

  • Specific
  • Measurable
  • Achievable
  • Realistic

Mindfulness Training is a method for reducing stress by being aware of the present situation, thoughts, and actions.  It can include meditation, controlled breathing, and many other exercises to help patients avoid ruminating on the past or on problems without solving them. Many great videos can be found online. Just know that results take some time, and it is important to routinely engage in mindfulness training to see an effect.

Vistaril, Atarax (hydroxyzine) is a prescription medication of the group of antihistamines with calming effects. To treat anxiety patients, take tablets or suspension orally, 50 to 100 mg 4 times a day.

Buspar (buspirone) is an antidepressant given for anxiety. It works by affecting neurotransmitters that transmit messages from one brain cell to another.

Selective Serotonin Reuptake Inhibitors (SSRIs) are antidepressants that work by increasing levels of serotonin in the brain. Serotonin helps carry messages between brain cells.

  • Prozac (fluoxetine) is taken for anxiety in capsule or liquid form at a dose of 20 to 80 mg per day.
  • Celexa (citalopram) is taken for anxiety by mouth in a dose of 10 to 40 mg per day.
  • Lexapro (escitalopram) is taken for anxiety by mouth at a dose of 10 to 20 mg per day.
  • Zoloft (sertraline) is taken for anxiety by mouth at a dose of 25 to 50 mg per day.
  • Paxil (paroxetine) is taken orally in a dose of 20 to 50 mg every day for anxiety 

Serotonin Norepinephrine Reuptake Inhibitors are antidepressants that work by increasing levels of serotonin and norepinephrine, another molecule that helps brain cells communicate.

  • Effexor (venlafaxine) is taken in an oral dose of 75 mg per day for anxiety.
  • Cymbalta (duloxetine) is taken by mouth in a dose of 30 to 60 mg per day for anxiety.
  • Pristiq (desvenlafaxine) is taken orally for anxiety in a dose of 50 mg daily.


Did you know? QuickMD can treat you for anxiety in the comfort and convenience of your own home. Physicians can prescribe non-controlled anti-anxiety medications for you online and help you find counseling or other resources.

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