Get 25% Off Your First Order
Anxiety disorders affect millions of people across the UK, making them one of the most common mental health conditions treated by GPs and specialists. Symptoms such as constant worry, panic attacks, poor sleep, physical tension, and difficulty concentrating can significantly reduce quality of life.
For many patients, medication plays an important role in managing anxiety when symptoms are persistent, severe, or do not improve with therapy alone. This guide explains the best medication for anxiety in the UK, including NHS-recommended treatments, how they work, potential side effects, and what patients should realistically expect.
What are the Best Medication for Anxiety in the UK?
There is no single “best” anxiety medication for everyone. In the UK, doctors follow NICE guidelines, which recommend specific treatments based on the type of anxiety disorder, symptom severity, medical history, and patient response.
In general, the most effective and commonly prescribed anxiety medications in the UK fall into the following categories:
- Pregabalin (generalised anxiety disorder)
- Benzodiazepines (short-term use only)
- SSRIs (first-line treatment)
- SNRIs (alternative first-line options)
- Beta-blockers (physical symptoms)
- Hydroxyzine (non-addictive short-term option)
Pregabalin (Generalised Anxiety Disorder)
Pregabalin is approved in the UK for the treatment of generalised anxiety disorder and is often prescribed when SSRIs or SNRIs are ineffective or unsuitable. It works by calming overactive nerve signalling in the brain, helping to reduce constant worry and physical tension.
Some patients experience symptom improvement more quickly with pregabalin compared to antidepressants, although it is still intended for regular use. It can be particularly helpful for people with long-standing or severe anxiety, especially when physical symptoms are prominent.
Pregabalin is prescribed with caution and reviewed regularly due to possible side effects such as dizziness, drowsiness, or weight gain.
Why Choose Pregabalin
- Approved for generalised anxiety disorder in the UK
- Used when SSRIs or SNRIs are not effective
- Calms overactive nerve signalling
- Reduces mental and physical anxiety symptoms
- May improve sleep and restlessness
- Requires ongoing medical review
Pregabalin is available in the UK in several standard pharmaceutical forms. All versions contain the same active ingredient and work in the same way; the main differences are the dosage strength, brand vs generic, and capsule formulation.
Generic Pregabalin
Generic pregabalin is the most commonly prescribed form on the NHS. It contains the same active ingredient as branded versions and is equally effective and safe. Generic pregabalin is available from multiple manufacturers and is usually the first choice due to lower cost.
Branded Pregabalin (Lyrica)
Lyrica is the original branded version of pregabalin. It is still available in the UK but is prescribed less frequently than generic versions. Lyrica and generic pregabalin are clinically equivalent.
Capsule Strengths Available in the UK
Pregabalin capsules are available in a range of strengths to allow gradual dose adjustment:
• 25 mg
• 50 mg
• 75 mg
• 100 mg
• 150 mg
• 200 mg
• 225 mg
• 300 mg
Formulation Type
Pregabalin is supplied as oral capsules. In the UK, it is typically taken once or twice daily depending on the prescribed dose and condition being treated.
Pregabalin is a prescription-only medicine in the UK and is classified as a controlled drug due to potential misuse. It should only be taken exactly as prescribed and reviewed regularly by a healthcare professional.
Benzodiazepines (Short-Term Use Only)
Benzodiazepines are fast-acting medications used in the UK for short-term relief of severe anxiety or acute panic attacks. Common examples include diazepam and lorazepam. They are not intended for long-term use and are prescribed cautiously due to the risk of dependence.
These medications work by enhancing the effect of GABA, a neurotransmitter that slows down brain activity. This produces rapid calming effects, often within hours, making benzodiazepines useful during crises or extreme anxiety episodes.
Why Choose Benzodiazepine
Benzodiazepines are prescribed in the UK for short-term management of severe anxiety, panic attacks, acute agitation, muscle spasms, and certain seizure disorders. Due to the risk of dependence, NHS guidance limits their use to short durations and specific clinical situations. The most commonly used benzodiazepines in the UK include the following:
Diazepam
Diazepam is one of the most widely prescribed benzodiazepines in the UK. It is used for short-term anxiety relief, panic attacks, muscle spasms, alcohol withdrawal, and severe agitation. Diazepam has a long duration of action.
Lorazepam
Lorazepam is commonly prescribed for acute anxiety, severe panic attacks, and agitation. It has a faster onset than diazepam and is often used in hospital or crisis settings.
Clonazepam
Clonazepam is primarily prescribed for epilepsy but sometimes used off-label for panic disorder and severe anxiety. It has a long-lasting calming effect.
Oxazepam
Oxazepam is oten used for short-term anxiety and alcohol withdrawal, particularly in older adults or those with liver impairment, as it is metabolised more safely.
Temazepam
Temazepam is mainly prescribed for short-term treatment of severe insomnia related to anxiety rather than daytime anxiety itself.
Chlordiazepoxide
Commonly used in alcohol withdrawal management and sometimes prescribed for short-term anxiety relief.
Despite their effectiveness, benzodiazepines carry significant risks if used for extended periods. Tolerance can develop quickly, meaning higher doses are needed for the same effect, and stopping suddenly can lead to withdrawal symptoms such as rebound anxiety and insomnia.
Frequently Asked Questions About Anxiety Medication in the UK
Why Choose Benzodiazepine Medications?
- Rapid relief for severe anxiety or panic
- Work quickly by calming brain activity
- Intended for short-term or crisis use only
- Risk of tolerance, dependence, and withdrawal
- Can cause drowsiness and impaired coordination
- Not suitable for long-term anxiety management
For this reason, NHS guidance limits their use to short durations, usually no more than two to four weeks.
SSRI Medications
SSRIs (First-Line Treatment)
Selective Serotonin Reuptake Inhibitors (SSRIs) are considered the first-line treatment for anxiety in the UK and are the most commonly prescribed long-term medication under NHS and NICE guidelines. They are recommended for most anxiety disorders because they are effective, well researched, and suitable for ongoing use when symptoms are persistent or significantly affect daily life.
Generalised Anxiety Disorder
SSRIs are commonly prescribed for generalised anxiety disorder, panic disorder, social anxiety disorder, post-traumatic stress disorder, and obsessive-compulsive disorder. They are also particularly useful when anxiety occurs alongside depression, which is a frequent combination. Because SSRIs address underlying brain chemistry rather than providing short-term sedation, they are designed to reduce anxiety steadily and sustainably.
These medications work by increasing the availability of serotonin in the brain. Serotonin is a neurotransmitter involved in mood regulation, emotional balance, and stress response. In people with anxiety, serotonin signalling can be disrupted, leading to heightened fear, constant worry, and difficulty coping with stress. SSRIs help stabilise this system, reducing both mental symptoms such as excessive worry and physical symptoms such as restlessness and tension.
Benefits of SSRIs
One of the main advantages of SSRIs is that they are suitable for long-term use. They are not addictive and do not cause cravings or dependency when taken as prescribed. This makes them safer than fast-acting anxiety medications for ongoing treatment and relapse prevention. Many patients remain on SSRIs for six to twelve months or longer, depending on symptom control and recurrence.
SSRIs do not work immediately. Most people begin to notice improvement after two to six weeks, with gradual benefits continuing over time. Some patients experience temporary side effects at the start of treatment, such as nausea, headaches, or increased anxiety, but these usually settle as the body adjusts.
When combined with psychological therapies such as Cognitive Behavioural Therapy, SSRIs form the foundation of effective, long-term anxiety management in the UK.
Why Choose SSRI Medications?
- NHS and NICE first-choice medication for anxiety#
- Effective for multiple anxiety disorders
- Improve serotonin balance to reduce fear and worry
- Non-addictive and suitable for long-term use
- Also improve sleep, focus, and emotional stability
- Most effective alongside therapy
How Long Does Anxiety Medication Take to Work?
Most long-term anxiety medications take time to show benefits:
- SSRIs and SNRIs: 2–6 weeks
- Benzodiazepines: within hours
- Hydroxyzine: same day
Who Should Consider Anxiety Medication?
- Persistent anxiety affecting daily life
- Frequent panic attacks
- Anxiety alongside depression
- Limited response to therapy alone
Who Should Avoid Certain Anxiety Medications?
- Pregnant or breastfeeding women
- Patients with heart, kidney, or liver issues
- People with a history of substance misuse
- Those taking medications that may interact
UK Prescription Pathway for Anxiety Medication?
- GP assessment and discussion of symptoms
- Referral to NHS Talking Therapies where appropriate
- Medication review after 6–12 weeks
- Ongoing monitoring for long-term prescriptions
Alternatives to Medication for Anxiety?
- Cognitive Behavioural Therapy (CBT)
- Mindfulness and relaxation techniques
- Breathing exercises
- Regular exercise and sleep improvements
- Stress management strategies
- Support groups
- Reducing caffeine and alcohol
What is the best medication for anxiety in the UK?
There is no single best medication for anxiety in the UK, as treatment depends on the individual. However, SSRIs such as sertraline and escitalopram are most commonly recommended as first-line treatments under NHS and NICE guidance due to their effectiveness and suitability for long-term use.
What anxiety medication do GPs usually prescribe first?
GPs in the UK typically prescribe an SSRI first. Sertraline is often used as an initial option because it is commonly well tolerated and effective across multiple anxiety disorders.
Are anxiety medications available on the NHS?
Yes. Anxiety medications are available on the NHS following assessment by a GP or specialist. Prescriptions are usually reviewed regularly and may be offered alongside NHS Talking Therapies.
What is the strongest medication for anxiety in the UK?
Benzodiazepines such as diazepam and lorazepam can provide fast relief and may be considered “strong” for short-term symptom control. They are not typically recommended for long-term use due to dependency and withdrawal risks.
How long do anxiety medications take to work?
SSRIs and SNRIs usually take 2 to 6 weeks to deliver noticeable improvements. Some short-term treatments like benzodiazepines or hydroxyzine may work within hours or days depending on the person and the dose.
Can anxiety medication make symptoms worse at first?
Yes. Some people experience increased anxiety, restlessness, or sleep changes during the first one to two weeks of starting SSRIs or SNRIs. This is usually temporary, but you should speak to your prescriber if symptoms feel severe or unmanageable.
Are anxiety medications addictive?
SSRIs, SNRIs, beta-blockers, pregabalin, and hydroxyzine are not generally considered addictive when taken as prescribed. Benzodiazepines can cause dependence if used for longer periods and are prescribed cautiously.
How long will I need to take anxiety medication?
Many patients take anxiety medication for at least 6 to 12 months, though this varies. The right duration depends on how well symptoms improve and whether anxiety returns when treatment is reduced.
Can anxiety medication be taken with therapy?
Yes. Many patients benefit most from combining medication with therapy such as CBT. This approach can reduce symptoms now while also building long-term coping strategies.
Can I stop anxiety medication suddenly?
No. Stopping suddenly can cause withdrawal symptoms and symptom rebound. Medication should be reduced gradually under medical supervision.
Conclusion
The best medication for anxiety in the UK depends on your diagnosis, symptom severity, and personal response to treatment. SSRIs remain the most commonly recommended long-term option, while other medications may be considered depending on your needs, side effects, and medical history.
For the strongest outcomes, medication is often combined with therapy and lifestyle changes. Always discuss options with a qualified healthcare professional to find the safest and most effective plan for you.
