Paroxetine—the most sedating of the SSRIs and often prescribed to assist anxious patients with sleep—produces significant declines in total sleep time, sleep efficiency, and total REM time, and increases awakenings and REM latency, and, may have the worst sleep profile of all SSRI's.
Mirtazapine may be more calming than other antidepressants for some people. Mirtazapine can also help appetite and sometimes is used off label exclusively for severe appetite and or weight loss.
Which SSRI Works Fastest? Escitalopram is an SSRI under the brand name Lexapro. Individuals taking it may notice therapeutic effects within the first week. It has the fastest known response of an SSRI and the mechanisms behind it are still being studied.
For Panic Disorder, Escitalopram and Sertraline Provide Greatest Benefit with Fewest Risks. In a meta-analysis, other agents also were effective but had more adverse effects.
As of this writing, some of the anxiety medications with the fewest reported side effects and least risk of side effects include: Most Benzodiazepines (Xanax, Valium) Bupropion (Wellbutrin) Citalopram (Celexa - SSRI)
The most common anti-anxiety medications are called benzodiazepines. Benzodiazepines are a group of medications that can help reduce anxiety and make it easier to sleep.
Abnormally low levels of serotonin have been linked to depression. SSRIs are thought to improve mood by boosting serotonin activity in the brain. But serotonin is not always a bed of roses. In the early days of treatment, it can increase levels of fear and anxiety and even suicidal thinking in some younger people.
Overall, citalopram appears to be the best-tolerated SSRI, followed by fluoxetine, sertraline, paroxetine, and fluvoxamine. The latter 2 drugs are associated with the most side effects and the highest discontinuation rates because of side effects in clinical trials.
While both medications are similarly effective in treating both MDD and anxiety, one study found that slightly more people stopped using Zoloft because of side effects compared to Lexapro (4% compared to 2%).
SSRIs and SNRIs increase the production of brain chemicals that help regulate your mood and stress response. This tends to make the medications especially effective for easing anxiety.
Lexapro is a selective serotonin reuptake inhibitor (SSRI) and Xanax is a benzodiazepine. Side effects of Lexapro and Xanax that are similar include drowsiness and weight changes.
Fluoxetine, which has the longest half-life of the SSRIs (see Table 1), appears to produce the fewest withdrawal symptoms, while paroxetine, which has the shortest half-life, produces the most pronounced discontinuation effects.
SSRI Sedation
The most sedating SSRIs are Luvox (fluvoxamine), Paroxetine (Paxil), and Citalopram (Celexa). Increasing daytime exercise can also be beneficial. If the SSRI is very effective. It may be worth adding a stimulating medication such as Wellbutrin, Provigil, or Strattera.
Sertraline hydrochloride, used for multiple mental health and mood disorders, is the most prescribed antidepressant on the list with more than 18 million prescriptions in 2021. Trazadone hydrochloride, used to treat anxiety and depression, is second on the list with more than 15 million prescriptions.
The most commonly prescribed ones include:
Selective serotonin reuptake inhibitors (SSRIs) are the most prescribed type of antidepressant and include: Fluoxetine. Citalopram. Sertraline.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) SSRIs and SNRIs are often the first-line treatment for anxiety. Common SSRI brands are Celexa, Lexapro, Luvox, Paxil, and Zoloft.
Lexapro is prescribed to treat depression and generalized anxiety disorder. Zoloft is prescribed to treat depression, obsessive compulsive disorder, and several other mental health conditions.
Lexapro (containing the active ingredient escitalopram) is a safe and effective treatment that is commonly prescribed for anxiety. Lexapro is an SSRI, which regulates serotonin production and reuptake in the brain to improve your moods and overall mental wellbeing to reduce symptoms of anxiety.
Trazodone (Desyrel) is a type of selective serotonin reuptake inhibitor (SSRI) doctors use to treat depression. However, doctors use it off-label to treat anxiety and insomnia. It works by restoring the levels of serotonin in the brain. A person can take it with a light snack or meal two or more times a day.
Some patients taking SSRIs develop insomnia, skin rashes, headaches, joint and muscle pain, stomach upset, nausea, or diarrhea. These problems are usually temporary or mild or both.
Although SSRIs can reduce symptoms, they cannot cure an anxiety disorder. Low serotonin levels are not the only cause of anxiety, so others may need addressing. Most people will also undertake some kind of psychotherapy⁹ (talk therapy), such as cognitive behavior therapy.
SSRIs usually need to be taken for 2 to 4 weeks before the benefit is felt. You may experience mild side effects early on, but it's important that you don't stop taking the medicine. These effects will usually wear off quickly.
Serotonin is a crucial chemical for increasing mood and decreasing anxiety. Researchers have found a clear connection between low serotonin levels and increases in depression, anxiety, and other mental health challenges.
Benzodiazepines
Benzodiazepines are a type of sedative drug that reduces the physical symptoms of anxiety, such as tense muscles. These drugs also encourage relaxation, and their effects take place quickly.