Anxiety pills otc

What Are the Best Options- K Health

Everyone copes with anxiety differently. For some individuals, prescription medication is the best way to keep this condition from controlling their lives.

For others, therapy, lifestyle changes, and over-the-counter medications and herbal supplements may help manage anxiety.

However, not all OTC options have scientific evidence to show that they do anything to treat anxiety.

Since the research can be difficult to interpret, we looked at the studies for you.

In this article, first we’ll explain why anxiety medications are only available by prescription.

Then we’ll discuss seven OTC options that have been shown to provide relief for symptoms of anxiety.

We’ll also share lifestyle changes that can help improve symptoms, as well as when to see a doctor or mental health professional about anxiety.

Why Anxiety Medication Is Prescription Only

Prescription drugs approved by the U.S. Food and Drug Administration (FDA) for the treatment of anxiety disorders include:

Selective serotonin reuptake inhibitors (SSRIs)
Serotonin norepinephrine reuptake inhibitors (SNRIs)
Buspirone (Buspar)
Benzodiazepines

These anti-anxiety medications work to affect neurotransmitters in the brain that can become unbalanced, leading to symptoms of anxiety.

They require a prescription because they can cause serious side effects and must be taken under the supervision of a medical provider.

Feeling down? Take our free assessment and learn about your options.

Get Started

OTC Anxiety Medications

Some people prefer trying OTC anxiety medicines before moving to prescription treatment.

Although these may not work for everyone, the ones below have some level of evidence for their effectiveness.

Discuss OTC remedies with your healthcare provider before taking anything, as these can interact with foods, prescription medications, or supplements.

Also know that supplements are not regulated by the FDA and may not contain the ingredients or doses they advertise, or could contain other unlisted ingredients.

Antihistamines

Most often used to treat allergies, antihistamines typically cause side effects of drowsiness or sedation.

Research has not found diphenhydramine (Benadryl) to be an effective anxiety treatment compared to anti-anxiety medications.

However, if anxiety symptoms interfere with sleep or are triggered by allergies, diphenhydramine or other antihistamines may help.

Older adults should be cautious with diphenhydramine since it can lead to dizziness or drowsy feelings, which could increase the risk for injury, falls, or confusion.

Diphenhydramine overdose can be fatal, so never take more than the dose listed on the package.

A prescription antihistamine, hydroxyzine (Vistaril), has been shown to be effective when taken as needed for anxiety.

Your healthcare provider can determine if that is a good treatment option for you.

5-hydroxytryptophan (5-HTP)

5-HTP, sometimes called tryptophan, is a compound found naturally in the body.

It is used to make several neurotransmitters, including serotonin.

Anti-anxiety medications often work by helping the brain recycle or increase levels of serotonin.

5-HTP is thought to be beneficial for anxiety by helping provide the materials the body needs to make more serotonin.

However, quality studies have not proven that it increases the amount of serotonin available to the brain or positively impacts mood.

Taking 5-HTP with other medications that influence brain chemicals could cause interactions.

Do not take 5-HTP with the following:

Antidepressants
Anti-anxiety medications
Stimulants
Sedatives
Muscle relaxers

Magnesium

Magnesium is a mineral required for many bodily functions, including muscle contraction, blood pressure and blood sugar regulation, and, possibly, mood balance and helping to alleviate feelings of anxiety.

While magnesium is found in many foods, nearly half the U.S. population does not consume enough.

The recommended daily intake is 310-420 milligrams (mg), depending on age and biological sex.

Too much magnesium from food does not pose risks, but high doses of magnesium supplements can cause diarrhea and other side effects.

Don’t take more than 350 milligrams of magnesium as a supplement.

CBD

Cannabidiol, or CBD, provides the calming properties of cannabis without the psychoactive component.

It may help treat different anxiety disorders, but more research is necessary to prove its safety and effectiveness.

Additionally, CBD products are not regulated by the FDA for dosage consistency, purity, or safety.

Many contain inconsistent amounts of CBD and may contain some psychoactive substances from marijuana or other contaminants.

So buy CBD products from trustworthy brands. Cannabidiol can also interact with medications.

Ashwagandha

Ashwagandha is an herb that may support balanced cortisol levels.

The body produces this hormone during times of stress.

Some clinical trials have found that ashwagandha has anti-anxiety properties, however, more research is needed to determine if this herbal remedy has effects in larger groups.

Kava

Kava, sometimes called kava kava, is a root sold as a dietary supplement.

A small study found that kava may help improve anxiety symptoms compared to a placebo.

Use caution with kava supplements, as they may cause liver damage that can be permanent and even fatal.

Valerian

Valerian root is commonly used for sleep problems.

One clinical trial found that this supplement led to improvements in the area of the brain associated with anxiety.

But not all studies show that valerian has anxiety-relief benefits, and if you take it regularly, you may notice withdrawal symptoms if you stop.

It also may have the potential to increase the risk of liver damage.

Lifestyle Changes

If you are interested in natural remedies to reduce anxiety, consider the following lifestyle changes:

Aromatherapy: Lavender essential oil is known for its soothing and calming effects. Diffuse it in a room or make a linen spray to use in your sleeping space or on your shirt. Never ingest essential oils or apply them directly to your skin.

Meditation and mindfulness: Meditation, deep breathing exercises, and mindfulness practices can help with anxiety symptom relief, especially when paired with psychotherapy and other methods of treatment.

Regular physical activity: In anxiety, it is thought that the HPA axis (a network of three glands) is hyperactive, causing the body to be stuck in “fight or flight” response for too long. Exercise can improve the function of the HPA axis and in turn improve mood, decrease stress, and modulate anxiety. Yoga in particular may provide anxiety relief.

Feeling down? Take our free assessment and learn about your options.

Get Started

When to See a Doctor or Mental Health Professional

If you experience symptoms of anxiety, speak with a healthcare provider about lifestyle changes and OTC options.

They can recommend supplements and other treatments that are likely to be better for you, considering your overall health and specific symptoms.

How K Health Can Help

Want mental health support?

K Health offers anxiety medication for the right candidates.

Get connected to care in minutes.

K Therapy offers free smart chats, which are dynamic, pre-written conversations designed by experts that cover a number of common mental health topics such as depression, anxiety, stress, relationships, and more. Access them for free by downloading the K Therapy app.

Online therapists are also available in select states for individualized care.

Connect with a licensed mental health therapist for unlimited asynchronous text-based therapy. Therapists respond Monday through Friday between 9am-5pm, within 24-hours.

Frequently Asked Questions

Are there any stress or anxiety medications available OTC?

The only FDA-approved treatments for anxiety require a prescription. However, some OTC medications and supplements may help address anxiety symptoms. Talk to a healthcare provider about your best options.

What are the strongest over-the-counter anti-anxiety medications?

Some dietary supplements (such as ashwagandha, CBD, valerian root, kava, and magnesium) may be helpful in easing anxiety but have not been proven to be safe or effective. In addition, supplements are not FDA-regulated and may not contain the advertised ingredients or doses.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Cannabidiol (CBD). (2022).
https://medlineplus.gov/druginfo/natural/1439.html
Cannabidiol as a Potential Treatment for Anxiety Disorders. (2015).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
The Effect of Yoga on Stress, Anxiety, and Depression in Women. (2018).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843960/
Effects of Aromatherapy on Anxiety: A Meta-Analysis of Randomized Controlled Trials. (2020).
https://pubmed.ncbi.nlm.nih.gov/32663929/
Exercise for Mental Health. (2006).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/
GABA-Modulating Phytomedicines for Anxiety: A Systematic Review of Preclinical and Clinical Evidence. (2018).
https://pubmed.ncbi.nlm.nih.gov/29168225/
Influence of Tryptophan and Serotonin on Mood and Cognition with a Possible Role of the Gut-Brain Axis. (2016).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728667/
An Investigation Into the Stress-Relieving and Pharmacological Actions of an Ashwagandha (Withania Somnifera) Extract. (2019).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292
Kava in the Treatment of Generalized Anxiety Disorder: A Double-Blind, Randomized, Placebo-Controlled Study. (2013).
https://pubmed.ncbi.nlm.nih.gov/23635869/
Kava Kava - LiverTox. (2018).
https://www.ncbi.nlm.nih.gov/books/NBK548637/
Magnesium. (2022).
https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional
Mindfulness-Based Interventions for Anxiety and Depression. (2018).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5679245/
Pharmacodynamic Response Profiles of Anxiolytic and Sedative Drugs. (2017).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396848/
Role of Magnesium Supplementation in the Treatment of Depression: A Randomized Clinical Trial. (2017).
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180067
Subclinical Magnesium Deficiency: A Principal Driver of Cardiovascular Disease and a Public Health Crisis. (2018).
ttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786912/
Treatment of Anxiety disorders. (2017).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573566/
Use of Cannabidiol in Anxiety and Anxiety-Related Disorders. (2019).
https://www.japha.org/article/S1544-3191(19)30514-X/fulltext
The Unexpected Identification of the Cannabimimetic, 5F-ADB, and Dextromethorphan in Commercially Available Cannabidiol E-liquids. (2018).
https://www.researchgate.net/publication/328677772_The_Unexpected_Identification_of_the_Cannabimimetic_5F-ADB_and_Dextromethorphan_in_Commercially_Available_Cannabidiol_E-liquids
Valerian - LiverTox. (2020).
https://www.ncbi.nlm.nih.gov/books/NBK548255/
Valerian Extract Alters Functional Brain Connectivity: A Randomized Double‐Blind Placebo‐Controlled Trial. (2019).
https://onlinelibrary.wiley.com/doi/10.1002/ptr.6286
What You Need to Know (And What We're Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. (2020).
https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis

Are There Any Over-The-Counter Anxiety Medications?

Anxiety medications are controlled substances for a reason. It all comes down to anxiety’s action within the brain.

Chronic anxiety (and panic attacks) can influence your central nervous system, causing your brain to release stress hormones such as adrenaline and cortisol more frequently than normal. This can result in various symptoms of anxiety, including depression, headaches, and dizziness.

Adrenaline and cortisol are extremely helpful when you’re in a threatening situation - they’re an essential component of your body’s fight-or-flight response, the reaction you have when exposed to dangerous situations. However, when you are responding to imagined threats (as is common with anxiety disorders), your brain is continually releasing stress hormones unnecessarily.

Therefore, to treat anxiety, treatment methods need to focus on preventing this neurological reaction. And anything powerful enough to affect the brain in this way you should only use after professional medical advice from a doctor.

And it’s important to ask yourself, “would I want over-the-counter medication for my anxiety?” Anxiety is not a disease that can be cured by taking some medication for a week. Instead, it’s a condition affecting the way you think and feel.

Medication dulls anxiety but it doesn't cure it. You'd have to take medication for the rest of your life, and that can lead to difficulties such as dependency, side effects, and a reduction in effectiveness over time. It may also prevent you from seeking further methods that could reduce your anxiety.

To truly combat anxiety, you need to understand why you’re anxious in the first place. You may need to speak to a mental health professional such as a therapist for this - more on that topic later!

Still, medications can help with the emotional distress and physical symptoms anxiety causes. So, why are there no over-the-counter treatment options?

Reason #1 Potential for Abuse

Taken in certain ways, anti-anxiety medications can cause significant mental impairment, and the concern is that if they were available over the counter, many people would be taking these drugs off-label. That's too dangerous.

Remember, these are drugs that affect your brain directly. They alter your body's production and reception of neurotransmitters. That can be useful for reducing anxiety but can cause significant side effects and be extremely dangerous if more is taken than directed. They also interact with numerous other medications, alcohol, and more. These medications simply cannot be sold over the counter without posing a significant risk to the community.

Reason #2 Side Effects

Even over-the-counter medications can elicit harmful side effects. And, without a doctor’s supervision, this could have serious repercussions. One example of this is Benadryl.

In the past, many people have used Benadryl to manage their anxiety symptoms because it’s fast-acting and convenient - taking just 15 - 30 minutes to kick in and lasting for several hours. Yes, it reduces anxiety symptoms temporarily, but Benadryl was never intended for long-term use. It comes with various side effects, including:

Fatigue
Dizziness
Drowsiness

And these are just the most commonly reported. Other, more severe side effects, include:

Lower red blood cell levels
Irregular heart rhythm
Rapid heartbeat
Confusion
Memory loss
Seizures
Hallucinations
Allergy

(Williamson, 2021)

With other medications, you may suffer from a decreased appetite, weight loss, and other adverse effects impacting your health. Without the assistance of a doctor, these side effects may be deadly. These can be particularly troublesome if you’re in a vulnerable group, such as pregnant women, the elderly, and young children.

Reason #3 Hands-Off Approach

In the short term, these medicines may provide some relief. But unfortunately, if you use these medicines for so long without any additional coping tips, your brain will start to depend on them as the only way to cope with stress.

As anxiety symptoms ease, you may feel a natural pull away from coping mechanisms you previously used to reduce your anxiety, reading to dependence on over-the-counter medication as your sole treatment approach.

So when you stop taking these medicines, you'll have lost some of your natural coping skills which, if you suffer from anxiety, may already have been struggling with. That's a significant risk without alternative treatments and a doctor's supervision.

Will Anxiety Medications Ever Be Available Over the Counter?

There may be a day when an over-the-counter anxiety medication is a viable option. Some medications, like Buspirone, are less powerful (while still useful for mild anxiety) and have fewer side effects.

It is possible that a medication like Buspirone may someday be released with a primary focus on easing anxiety symptoms, but given that it can also take several days for the medications to start working, and they are not as powerful as benzodiazepines and other prescription medications, it still may not be the right choice.

Someday there will be an over-the-counter anxiety medicine, but as of yet, there are no medications that meet the criteria that would make them viable as an over-the-counter option.

Alternatives to Over-the-Counter (OTC) Anxiety Medications

Until OTC medications become available, there are several effective alternatives that you could try. Let’s look at each option in turn.

Talk Therapy

Talk therapy has proven a highly effective method for managing anxiety symptoms. One of the most common forms of therapy for anxiety disorders is Cognitive Behavioral Therapy (CBT).

In CBT, you work with a therapist to identify the factors contributing to your anxiety, focusing on problem-solving rather than digging deep into the past, unlike other therapy approaches such as psychodynamic and humanistic.

Exercise

Researchers extensively study the benefits of exercise on mental health and well-being. One of the positive effects of regular exercise is that it reduces anxiety. It does this in several ways:

Distraction

Exercise provides a welcome distraction from anxious thoughts and the physical symptoms associated with chronic anxiety.

Reduces Muscle Tension

Exercise gets your muscles active, which can help to reduce muscle tension and other anxiety effects on your muscles.

Increases Heart Rate

Exercise makes your heart beat faster, which alters your brain chemistry, encouraging the release of anxiolytic (anxiety-reducing) neurochemicals such as GABA, serotonin, and BDNF.

Activates Specific Brain Regions

Your frontal brain regions are activated when you exercise. These areas are responsible for executive function, enhancing control over the amygdala, an area of the brain related to the stress response.

Herbal Remedies

There are also several herbal ingredients that reduce anxiety. This includes:

Kava. Kava is an herbal supplement that some studies have shown may be as effective as several anxiety medications. Kava should still be used under the supervision of a doctor since it can interact with other medicines and alcohol, but as it is an herb that is available without a prescription, it may be worth trying. Passionflower and valerian may also be beneficial, although they are not believed to be as powerful.
CBD oil. CBD oil is an extract of the cannabis plant (known as Cannabidiol). It is usually taken from industrial hemp, which contains very little THC (the drug that causes the high), and even then any remaining THC is completely removed. Although we cannot recommend CBD oil yet due to a lack of research and questionable legality, there are studies showing that this extract may have stress relief benefits. Talk to your doctor about the risks and benefits of CBD.
5-HTP, L-Tryptophan, or Sam-e. Although many neurotransmitter imbalances have been linked to anxiety, serotonin is the one that has the strongest connection for most people. In theory, increasing serotonin levels in the brain should be able to decrease anxiety symptoms. According to natural health promoters, 5-HTP, L-Tryptophan, and Sam-e are three supplements that increase serotonin levels. It is not clear that they work in the research, but they are available over the counter for those interested in trying it.
Water and Magnesium. In some cases, anxiety may be caused or exacerbated by a lack of important nutrients. So drinking a lot of water and taking magnesium supplements may help some people reduce their anxiety and find some degree of relief, even if it doesn't cure the anxiety altogether.

To learn more, read our article on natural remedies for anxiety.

None of these are guaranteed immediate cures, but they can be a tremendous help. If you're someone that benefits from relaxation exercises like deep breathing, progressive muscle relaxation, and visualization, then you should try those as well.

You should never self-medicate with alcohol, or with any drug not designed for anxiety. Self-medication has the same effect as anxiety medicines - use them when you're feeling anxious, and you start to depend on them and lose your ability to cope any other way.

Next Steps for Anxiety

Anxiety isn’t a quick fix. You need to work on it regularly and learn the skills necessary to reduce anxiety, as well as figure out the cause of your anxiety in the first place.

While many consider taking medication a short-term solution, it can often turn into a long-term problem, especially if consumption isn’t supervised by a doctor.

However, there are some approaches you can take to manage anxiety yourself, such as talking therapy, exercise, and herbal remedies. But be sure to speak to your healthcare provider to identify the best course of action for you.

SUMMARY

There are no OTC medications for anxiety since any medication that affects the brain needs to be carefully monitored; that’s why they tend to be prescription medication only.

Medication is not the only treatment a person should take as it can lead to dependency, unpleasant side effects, and reliance as the only coping strategy.

Luckily, there are other natural remedies for treating anxiety, including talk therapy, exercise, and herbal products. Ultimately, more research is needed to uncover a truly effective over-the-counter medication for anxiety.

Was this article helpful?

top-5 rating according to KP

Everyone knows the phrase “all diseases are from nerves”. Indeed, prolonged stress undermines our health, reduces immunity. As a result of constant failures, diseases to which a tendency has been observed develop. For example, if you have relatives with hypertension, you have a high risk of developing the disease after prolonged stressful conditions.

Short-term stress and emotional outbursts usually do no harm. Much more dangerous is the sluggish nervous tension that often occurs among residents of megacities. Lack of sleep, city noise, worries at work lead to prolonged, but unnoticed depression, fatigue, mood and sleep disorders. This can drag on for years, until the person "breaks loose", falling into a panic or aggressive state.

Many people unknowingly develop bad habits such as smoking and drinking alcohol to relieve stress. Toxic substances exacerbate the situation.

You can keep your nervous system healthy in other ways. Go in for sports, walk in the fresh air, consult a psychotherapist, take supportive drugs. Light drugs are not addictive and act on the brain quite gently. Therefore, you can buy the best pills for stress and nerves without prescriptions.

Top 5 rating according to KP version

1.

Lotosonic Lotosonic

Combined herbal medicine. It has anxiolytic and anti-stress activity. It is produced in Vietnam, so its recipe contains components that are widely used in traditional oriental medicine. It consists of extracts of seeds and embryos of the walnut lotus, seeds of thuja orientalis and Chinese dates, rhizomes of Dioscorea, mulberry leaves and erythrina, as well as the fruits of euphoria longana.

Components of Lotusonic reduce irritation and tension, which are manifested in mental fatigue and neurasthenia. When taking other sedative, hypnotic drugs, as well as antihypertensive and analgesics, the dosage should be adjusted, since the drug enhances their effect. The effect of Lotusonic is cumulative, as with most herbal preparations.

natural herbal composition based on recipes of traditional oriental medicine; indicated for increased excitability, irritability, fatigue; additionally, with insomnia, it helps to restore normal sleep; not addictive; low price.

not allowed under 18; can not be pregnant and lactating; allergic reactions are possible; during the period of treatment should refrain from driving.

Lotusonic

Helps to fight stress manifestations

Combination medicine Lotusonic has anti-stress activity and helps to cope with irritation and tension. It contains herbal ingredients used in traditional oriental medicine

Get priceView ingredients

THERE ARE CONTRAINDICATIONS. CONSULT WITH A SPECIALIST

Advertisement. DOMINANTA-SERVICE JSC. Photo: market.yandex.ru

This drug is usually prescribed as an additional support for the brain with constant overstrain: stressful work, difficult studies. Tablets regulate metabolism and improve the processes of inhibition in the central nervous system. This reduces tension and aggression.

Also, the drug reduces the consequences after brain injuries, after alcohol or drug poisoning.

improves mental performance; improves sleep; no side effects; possible during pregnancy and children; low price

cumulative effect, not effective immediately

3.

Novo-Passit solution Novo-Passit. Photo: TEVA

Herbal preparation, consists of a complex of valerian, hops, lemon balm and others. The herbal complex has a calming effect, effective not only with anxiety, but also with more severe disorders. For example, with itching, migraines, intestinal diseases, bouts of neurasthenia, which are caused by psychological stress.

The product contains ethanol - alcohol, which should be taken into account. During pregnancy, the drug is not recommended to be taken, but according to certain indications, they are at risk. For convenience, there is also a form of tablets, but the solution is absorbed and acts faster.

natural composition; fights many nervous diseases; improves sleep; palatable

possible side effects; recommended to stop driving; not allowed under 12 years of age; not for breastfeeding mothers; inconvenient form of reception; not compatible with certain medications; high price

4. Afobazole

Afobazole tab.

Photo: market.yandex.ru

This drug is one of the most “strong” in our ranking of the best pills for stress and nerves, it belongs to tranquilizers and antidepressants. It is used for anxiety, anxiety attacks, sleep disorders. It also facilitates the course of many diseases: asthma, hypertension, arrhythmias.

The drug is especially indicated for vulnerable, suspicious people, prone to tearfulness or irritability. Taking pills makes it easier to endure premenstrual syndrome, as well as the "withdrawal syndrome" with a sharp rejection of bad habits, smoking and alcohol.

protects nerve cells; eliminates anxiety; relieves depression; fights many nervous diseases; does not cause lethargy and addiction; practically no side effects.

not allowed under 18; not during pregnancy and lactation; cumulative effect, does not appear immediately; high price.

5. Motherwort forte

Motherwort forte tab. Photo: market.yandex.ru

In fact, it is not a medicine, but a dietary supplement, a source of vitamins, magnesium and flavones. Their accumulation has a very mild calming effect and is suitable for minor anxiety as an additional support for the body. With severe stress and its physical manifestations, the drug may not work immediately. Sometimes you have to take pills for more than a week before the effect appears.

natural composition; reduces the level of anxiety; no side effects; does not cause addiction and drowsiness; low price.

cumulative effect; not allowed under 18 years of age; not allowed during pregnancy and lactation.

How to choose pills for stress and nerves

You should not prescribe even light sedatives on your own. Most likely, they will not cause direct harm, but they can “blur” the picture of the course of a nervous disease. You may actually need a different type of medication and psychotherapy sessions. Therefore, it is better to consult a neurologist or a psychotherapist.

“The drug should be chosen according to the problems. If you experience "bodily anxiety" - a feeling of tingling in the body, a coma in the throat, a feeling of lack of air, pressing pains and tightness behind the sternum, it is better to choose drugs with the properties of a vegetative stabilizer. They stabilize that part of the nervous system that is responsible for the activity of organs and blood vessels. Disorder in the work of the autonomic nervous system due to stress can cause discomfort in the body,” says neurologist Irina Ignatova .

Additionally, you can take various nootropics - drugs that stimulate the brain. This will help him cope with complex mental work and recover faster.

For mental anxiety, obsessions, difficulty falling asleep, sedatives are suitable: homeopathic remedies or plant-based sedatives. They suppress the excessive activity of the central nervous system and soothe.

7 anti-anxiety remedies

Daniil Davydov

medical journalist

Author profile

Many people now experience anxiety, and it can be difficult to deal with it on your own. About what ways can really help, we wrote in the article "5 tips on how to cope with anxiety in difficult times."

However, some popular medications and supplements that are marketed as anti-anxiety medications have no evidence of effectiveness.

Some of them are relatively harmless, but others have side effects and contraindications, so under certain conditions they can do more harm than good. If you are planning to purchase a medication for anxiety, we recommend that you consult with your doctor. And this list will help you make an informed decision.

Essential Skills in Times of Stress - WHO Picture Guide

What You Will Learn

Novo-Passit
Persen
Corvalol
Motherwort
Validol
Afobazole
Tenoten

Go to the doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

Novo-Passit

What is it. Phytotherapeutic tablets or solution based on herbal extracts of valerian officinalis, lemon balm, St.

Novo-Passit - GRLS

According to the manufacturer, the drug helps with a state of constant mental stress and mild forms of insomnia.

Proof of effectiveness. Novo-Passit is not mentioned in the international drug databases, nor is it in the clinical recommendations for the treatment of any diseases.

/list/medical-evidence/

14 authoritative medical sources

Some drugs are made from chemicals derived from plants. For example, cardiac glycosides are made from digitalis purpurea. But for the manufacture of the drug, not the whole plant and not the extract from it are used, but separate, carefully purified chemicals, the concentration of which is very strictly controlled.

Products containing extracts or whole parts of one or more plants are classified as herbal medicine and are considered dietary supplements in most countries. Therefore, they are neither in international drug databases nor in clinical guidelines for the treatment of diseases.

What is Phytotherapy - MedlinePlus Medical Guide

There is no need to look for evidence of the effectiveness of dietary supplements, since by law it is just food.

All that is required of them is to be safe, that is, not to harm the health of the people who take them. Since it is not necessary to prove the effectiveness of herbal remedies, they are very poorly studied. When it comes to complex herbal remedies, research is further complicated by the fact that they do not work the way they would work separately.

/dietary-supplements/

They say expensive dietary supplements are more effective than cheap ones. Is it true?

For example, although the European Medicines Agency, or EMA, considers valerian essential oil and rhizome preparations to have a calming effect, we do not know how this plant extract will work in combination with other plant extracts.

Valerian essential oils - EMA

Valerian rhizomes - EMA

Finding out how effective a multi-herb formulation works is also difficult because different researchers study different sets of herbal extracts at different concentrations. As a result, most scientists admit that we do not yet have reliable information on how effective herbal preparations based on herbs are for anxiety.

For example, psychotherapists in Switzerland who were trying to understand whether a combination of extracts of valerian, lemon balm, passionflower and butterbur helps with anxiety disorders. They gave part of the patients these supplements and compared the effect with patients who did not receive supplements, and came to the conclusion that the supplements can reduce the dosage of the main drugs - benzodiazepines.

Effect of a combination of valerian, lemon balm, passionflower and butterbur extracts on benzodiazepine prescribing in hospitalized patients with psychiatric disorders - Journal of Phytotherapy

These types of studies are called case-control studies. Even if they show that patients got better, this cannot be considered conclusive evidence of the effectiveness of the drug, since doctors knew who was receiving which drug and could unwittingly embellish the result. Patients who received supplements could also believe in their power and feel better - this is called the placebo effect.

To understand how well supplements really work, you need to study them the way you study drugs, that is, subject them to a randomized clinical trial. With this procedure, patients are randomly divided into two groups, one of which receives the drug, and the other receives exactly the same type of dummy pills, and neither doctors nor patients know which group they fell into until the end of the experiment. But there are still no such works devoted to supplements with herbal extracts for anxiety. Until they appear, nothing definite can be said about whether they work.

Another component of Novo-Passit, guaifenesin, is known mainly as a cough suppressant and expectorant. There is still no convincing evidence that guaifenesin helps with coughing - but it has quite a few side effects.

Guaifenesin - a cough remedy - drugs.com

I have not been able to find studies of guaifenesin as an anti-anxiety agent.

Contraindications and side effects. In the instructions, the manufacturer writes that Novo-Passit is contraindicated in children under 12 years of age and people with intolerance to the components of the drug - especially guaifenesin. As a rule, it is well tolerated, but some people complain of allergies, dizziness, weakness, drowsiness and gastrointestinal disorders - from vomiting and heartburn to diarrhea.

The cost of the drug depends on the number of tablets in the package and the volume of the vial

A package of 10 tablets and a bottle of 100 ml solution cost about the same - 460-470 R

The cost of the drug depends on the number of tablets in the package and the volume of the vial A package of 10 tablets and a 100 ml solution bottle cost approximately the same - 460-470 R

Persen

What is it. Phytotherapeutic tablets and capsules based on the extract of rhizomes of valerian, lemon balm and mint.

Persen — GRLS

According to the manufacturer, the drug has a sedative effect.

Proof of effectiveness. Persen is not mentioned in the international databases of medicines, it is also not in the clinical recommendations for the treatment of any diseases. This is a phytotherapeutic drug similar to Novo-Passit, but with a slightly different composition. He has exactly the same problems with evidence of effectiveness.

Contraindications and side effects. According to the manufacturer, the drug should not be taken by people with hypersensitivity to its components, people with low blood pressure, diseases of the biliary tract, children under 12 years of age, pregnant and lactating women. The drug can cause allergic reactions - from rashes to edema, and with prolonged use, provoke constipation.

The cost of the drug depends on the number of tablets in the package. The price of a pack of 20 tablets is 351 R

Corvalol

What is it. Corvalol is sold in two versions:

phytotherapeutic agent based on extracts of lemon balm leaves, peppermint and motherwort grass in tablets and water-based drops;
phytotherapeutic agent based on extracts of lemon balm leaves, peppermint, motherwort herb, which contains phenobarbital. These are drops based on 95% alcohol.

Corvalol tablets - GRLS

Corvalol drops with phenobarbital - GRLS

According to the manufacturers, Corvalol in both versions "has a calming effect."

Proof of effectiveness. As an anxiety remedy, both versions of Corvalol, both with and without phenobarbital, are not mentioned in any international drug database. In clinical recommendations for the treatment of any diseases, they are also absent.

There is no convincing evidence that any of the components of Corvalol without phenobarbital can work as a sedative. According to some studies, lemon balm tea or tincture relieves insomnia, and the smell of peppermint can reduce stress a little. But there is no evidence that in tablets or drops these components will act in the same way as in the form of tea or essential oil.

Perhaps lemon balm tea or tincture helps with insomnia - RxList

Perhaps the smell of mint can relieve stress - RxList

Why phenobarbital is dangerous - drugs.com

Corvalol with phenobarbital may indeed have a sedative effect - for account, in fact, phenobarbital. This is a very old tranquilizer, in most countries its is prescribed only as an anticonvulsant and its use is strictly controlled, since phenobarbital is addictive and has many side effects.

Contraindications and side effects. Manufacturers of Corvalol without phenobarbital warn that it has quite a few contraindications: from allergies to its components to peptic ulcer, liver or kidney diseases, pregnancy and breastfeeding. Children under 18 years of age should not take the drug.

Manufacturers of Corvalol with phenobarbital add alcoholism and traumatic brain injury to the list of contraindications. Experts from other countries warn that phenobarbital is also contraindicated in severe asthma and chronic obstructive pulmonary disease, i.e. COPD, porphyria, and for people with a history of drug dependence in the past. The list of side effects of phenobarbital drops includes dizziness, weakness, nausea, decreased alertness, and rash.

/list/kardiologia/

14 important questions for Anton Rodionov, a cardiologist

tablets

Preparations and supplements with motherwort

What is it. Phytotherapeutic agents based on motherwort extract. According to the manufacturers, such drugs have a pronounced sedative effect - that is, they work as a strong sedative.

Preparation based on motherwort extract - GRLS

Motherwort-based supplements registered in Russia

Motherwort as a source of bioactive compounds - European Medicines Agency report medical reference book RxList

In Russia, there are both medicines and biologically active supplements based on motherwort - both in the form of liquid extracts and in capsules.

Proof of effectiveness. Motherwort-based preparations are not listed as an anxiety remedy in any international drug database. In clinical recommendations for the treatment of any diseases, it is also absent.

Theoretically, motherwort may have a potential neurological effect. Some substances in this plant can bind to receptors for gamma-aminobutyric acid, or GABA. This neurotransmitter is responsible for the inhibition of the nervous system, so the researchers suggested that the biologically active substances in motherwort would work in a similar way.

But when the substances in the motherwort extract that could work as sedatives were tested separately, their biological effect was very weak. Most likely, patients with anxiety would simply not feel its effects.

The effectiveness of motherwort remedies in healthy people with severe anxiety has not been tested. According to some studies, the combination of motherwort, valerian, hops, and lemon balm improves sleep in people with alcoholism who are trying to quit drinking. However, there is no conclusive evidence for this yet.

Contraindications and side effects. Motherwort preparation companies warn that some people may have allergies or digestive disorders - indigestion, that is, pain or discomfort in the stomach, and diarrhea.

Motherwort preparations and supplements are contraindicated in people taking neurological preparations based on calcium hydroxybutyrate, magnesium hydroxybutyrate, potassium hydroxybutyrate, or sodium hydroxybutyrate. Motherwort can enhance the effect of such drugs - up to severe poisoning and coma.

Motherwort is incompatible with hydroxybutyrates - Medscape Medical Guide

Some pharmaceutical companies offer motherwort extract based on 70% alcohol. According to the instructions, you need to use the drug in 30-50 drops diluted in water - the maximum content of ethyl alcohol in such a dose is 0.55 g, and in the maximum daily dose - 2.2 g.

International organizations believe that women can take no more than one standard serving of alcoholic beverages per day, and for men - no more than two servings. This is 14 g of pure ethanol.

The amount of ethyl alcohol that can be obtained with the maximum dose of the drug is much less than the standard serving of alcohol. Nevertheless, people who take drugs that are incompatible with alcoholic beverages, such as antidepressants, should, just in case, abandon the alcohol tincture of motherwort.

The cost of the drug depends on the pricing policy of the manufacturer. The cheapest package of 10 tablets can be bought for 18 R

Validol

What is it. Sublingual tablets based on levomenthol - a substance that is obtained from peppermint essential oil.

Validol - GRLS

Manufacturers claim that this drug "has a sedative effect" - that is, it works as a sedative.

Proof of effectiveness. As a remedy for anxiety, levomenthol-based drugs are not mentioned in any international drug database.

In some countries, levomenthol is approved only as an external agent for veterinary use. It is mainly used as a cough suppressant, anti-inflammatory and antipruritic drug in humans and animals.

Levomenthol — drugs.com

How levomenthol is used in medicine — PubChem chemical guide

No one has studied the effectiveness of peppermint essential oils and levomenthol preparations for anxiety in people.

Contraindications and side effects. There are few contraindications for drugs with levomenthol: mostly it is an allergy or intolerance to the components of the drug, the medicine is not suitable for children under 18 years of age. But there are side effects: nausea, watery eyes and dizziness. According to the manufacturers, the drug is incompatible with alcohol.

The cost of the drug depends on the number of tablets in the package and on the pricing policy of the manufacturer. The cheapest package of 20 tablets costs 54 R

Afobazol

What is it. A drug based on a substance that received the international name fabomotizol. In our country, "Afobazol" of immediate and delayed action is sold. In the delayed-release preparation, the concentration of the active substance is three times higher, and it is absorbed during the day.

Afobazol - GRLS

According to the manufacturers, tablets with fabomotizol reduce anxiety and stimulate the nervous system.

Proof of effectiveness. Fabomotizole-based drugs are not listed as anti-anxiety drugs in any international drug database.

The effectiveness of "Afobazole" as a remedy for anxiety was studied only in Russia - the drug is not used anywhere else in the world. I could not find independent studies on the effectiveness of the active substance for anxiety.

Contraindications and side effects. Among the contraindications, the manufacturer lists only individual intolerance to the components of the drug, age under 18, pregnancy and the period of feeding a child. And among the side effects are allergies and headaches.

An immediate drug. Price: 720 R

Delayed drug. As a rule, slow-acting drugs are more expensive. Price: 894 R

Immediate drug. Price: 720 Р Delayed action drug. As a rule, slow-acting drugs are more expensive. Price: 894 R

Tenoten

What is it. Lozenges based on lactose sugar. The composition of the drug intended for adults includes antibodies to the brain-specific S-protein at a concentration of 10 ^-15 ng / g, and the children's version - 10 ^-16 ng / g.

Tenoten for adults - GRLS

According to the manufacturer, it has a calming and anti-anxiety effect.

Proof of effectiveness. The concentration of the active substance makes it possible to recognize Tenoten as a homeopathic remedy, since at a concentration of 10 ^-15 -10 ^-16 ng / g, not a single antibody may appear in the tablet. But even if there were more antibodies, manufacturer-independent data that antibodies to the brain-specific S-protein reduce anxiety, no.

Learn more