Being a teenager can be stressful, both for kids and their parents. Many teenagers experience overwhelming anxiety and lack the tools to cope with it. Some adolescents worry intensely, struggle to sleep, obsess over the same negative thoughts, and have trouble socializing with others. They may even experience physical symptoms like nausea, fatigue, or muscle aches. In these cases, a teenager might have a diagnosable anxiety disorder.

An untreated anxiety disorder puts a teenager at risk of lower school performance school, poor social skills, and risky behaviors like substance abuse. Mental health professionals generally agree that therapy should be one course of treatment for teens with anxiety. Cognitive behavioral therapy (CBT) is the most commonly-used type of talk therapy for teens. CBT helps adolescents challenge negative thoughts they have about themselves or the world and also engage in positive ways of coping. Many therapists also use exposure therapy techniques with teens, helping them face their fears and learn to navigate being an adult in the world.

Some mental health professionals may recommend that teens take anxiety medication in conjunction with psychotherapy. For teens, medication may be prescribed in the short-term or the long-term, depending on the nature and severity of symptoms. Let’s take a look at the most commonly prescribed types of anxiety medications for teens.

Types of Anxiety Medications

Selective Serotonin Reuptake Inhibitors (SSRIs)—SSRIs are antidepressants that are also commonly prescribed to treat anxiety. They improve mood by blocking the reuptake of the neurotransmitter called serotonin. SSRIs are usually the first type of medication prescribed to teens to treat anxiety disorders and also the most commonly prescribed class of medication for teens with anxiety. Side effects typically include nausea, headaches, and sleep problems. Side effects can take days or weeks to subside, and it’s important that your teen not discontinue use abruptly or without the guidance of a doctor. Premature discontinuation can lead to flu-like symptoms.

There are a small number trials studying the effects of SSRIs for adolescents with anxiety disorders. Most of the SSRIs approved by the FDA for use in adolescents with anxiety disorders have been approved to treat obsessive compulsive disorder (OCD). Trials have found that sertraline (Zoloft), fluoxetine (Prozac), fluvoxamine (Luvox), and paroxetine (Paxil) were beneficial in treating OCD. SSRIs have also demonstrated in trials that they are beneficial in treating kids with generalized anxiety disorder (GAD), separation anxiety disorder (SAD), and social phobia.

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Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)—SNRIs work by increasing serotonin and norepinephrine and preventing brain cells from reabsorbing them. SNRIs can have side effects similar to SSRIs and can also take several weeks to achieve their full effects. Few studies have been conducted on SNRIs for treating anxiety disorders in teenagers, but venlafaxine XR (Effexor) has shown to be effective. Your teen’s doctor will choose between an SSRI and a SNRIs based on the potential side effects, the potential interaction effect with other medications they take, and your family’s history of how these medications have been received.

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Tricyclic Antidepressants (TCAs)—If SSRIs or SNRIs are ineffective, your teen’s doctor may prescribe a tricyclic antidepressant. The FDA approved clomipramine for the treatment of obsessive compulsive disorder and the medication is sometimes used to treat social anxiety. There is a risk of serious side effects when taking TCAs, such as constipation, sedation, and cardiac abnormalities. People who take TCAs may require regular EKGs to monitor their cardiac health.

Benzodiazepines—Benzodiazepines are not considered a first course of treatment for teens with anxiety because there is a risk of developing a tolerance to the drug and becoming addicted. Benzodiazepines include alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan). Teens who discontinue the use of benzodiazepines can also experience powerful withdrawal symptoms. Sometimes these drugs are prescribed with SSRIs until the SSRI reaches its full effect. There are no controlled trials which show the benefit of using benzodiazepines to treat anxiety in children, even though these drugs are sometimes prescribed. Talk to your teen’s doctor about the benefits and potential risks of taking them.

Medication Management and Risks

If your teen is taking, or considering taking, medication for anxiety, it is important to speak with them consistently about their experience with the medication, especially about any side effects they may be experiencing. Report side effects to their doctor and talk to their doctor before you and your teen decide to discontinue any medication. It may take more than one try to find the right anxiety medication for your teen and some doctors may recommend genetic testing that can help them determine which class of medications may work best.

Also be sure to talk to your teen about the risks of using alcohol and other drugs while taking anxiety medication. Drinking alcohol can worsen side effects of any anxiety medication and drinking while taking benzodiazepines is extremely dangerous. Remind your teen that they should not give or sell their medication to anyone else, nor should they should take medication prescribed to anyone else. If your child is taking benzodiazepines, talk to them about the risks of habit-forming potential and monitor their use of the medication.

Antidepressants like SSRIs and SNRIs carry warnings that they may increase the risk of suicidal thoughts and self-harming behavior, particularly among young people. Although the risk is low, communicate with your teen about side effects so that you will know if they are experiencing any suicidal thoughts.

When considering anxiety medication for your teenager, write down a list of questions you have and bring them to your child’s doctor or mental health professional. Some of these might include:

  • How long will the medication take to be fully effective?
  • What side effects are most common?
  • Will the side effects subside after a period of time?
  • Are there any health risks associated with taking this medication?
  • Are there any negative side effects commonly associated with discontinuing the medication?
  • Will this medication interact negatively with any other medications the teen is taking?

It may take several attempts to find the right medication for them and these needs may change over time. Some medications can take up to a month to achieve their full effect and for a doctor to determine whether they are effective.

To expedite this process, your child’s doctor may recommend genetic testing to help determine which medication to which they might respond the best. This type of genetic testing is done via cheek swab. Unfortunately, not all insurance companies are completely on board with genetic testing, so be sure to speak with your insurance company and your doctor before approving any genetic testing with which your doctor wants to go through. Also, if your child experiences additional mental health symptoms or challenges, medication may have to be altered. With the right information and continued communication with your teen, they will feel empowered to manage their anxiety and live a healthy life unencumbered with constant fear or worry.

DISCLAIMER: The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider.  This article mentions drugs that were FDA-approved and available at the time of publication and may not include all possible drug interactions or all FDA warnings or alerts. The author of this page explicitly does not endorse this drug or any specific treatment method. If you have health questions or concerns about interactions, please check with your physician or go to the FDA site for a comprehensive list of warnings.

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Last Updated: May 29, 2018