Parents of anxious teenagers—as well as the teens themselves—are often desperate for help. How do you know when the anxiety rises to the level of requiring treatment? Or maybe you have concerns about whether anxiety medication is safe for this age group. This article covers a few ways to tell when anxiety treatment may be necessary for teens. It also provides information about anxiety medication for teens, its potential side effects, and medication-related safety warnings.
When to Seek Treatment for Teen Anxiety
There are many different types of teen anxiety, including:
Generalized anxiety Panic disorder Post-traumatic stress disorder (PTSD) Separation anxiety Social anxiety
Anxiety becomes problematic when it affects a teen’s social, occupational, or educational functioning. Here are a few examples of when a teen may benefit from anxiety treatment:
The teen thinks everyone is always staring at them. As a result, they refuse to eat lunch in the cafeteria and avoid talking in class.The teen survived a near-fatal car accident on a rainy evening. Several months later, they continue to have nightmares and flashbacks. They also refuse to get in a car when it’s raining.The teen has started experiencing panic attacks. They’re worried a panic attack will happen at school, so they’ve started refusing to go.
Approximately 60% of young people with an anxiety disorder don’t get treatment. But anxiety is treatable. Along with cognitive behavioral therapy (CBT)—also known as talk therapy—medication is also an effective teen anxiety treatment.
Using Medication to Treat Anxiety
Prescription medications can be useful in the treatment of anxiety disorders. They are also often used in conjunction with CBT. Research studies show that a combination of CBT and medication works better for children than either treatment alone. That said, when teens have mild to moderate functional impairments, the American Academy of Child and Adolescent Psychiatry recommends deferring the use of medication.
Types of Anxiety Medications for Teens
It can be challenging to find the right anxiety medication that will work for your teen. Here are a few that a physician may prescribe.
SSRIs and SNRIs
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medication for anxiety in children and teens. They improve mood by blocking the reabsorption of serotonin—a neurotransmitter that helps regulate fear, worry, and stress—in the brain. Common SSRIs used to treat anxiety disorders in teens include:
Celexa (citalopram) Lexapro (escitalopram) Prozac (fluoxetine) Zoloft (sertraline)
Serotonin-norepinephrine reuptake inhibitors (SNRIs) may be prescribed if SSRIs don’t have the desired effect. Like SSRIs, SNRIs impact neurotransmitters in the brain. They block the reabsorption of serotonin and norepinephrine. SNRIs may include medications such as Cymbalta (duloxetine) and Effexor XR (venlafaxine). It can take up to 8 weeks for these types of medications to work. If the teen tolerates the medication well and hasn’t received the results desired, the dosage may be increased after several weeks.
Benzodiazepines
Although SSRIs and SNRIs are most commonly used to treat anxiety in teens, other prescriptions may be used as well. Benzodiazepines are the second most commonly used type of medication and may be prescribed to teens with severe anxiety. Medications in this category include:
Klonopin (clonazepam) Valium (diazepam) Xanax (alprazolam)
Benzodiazepines are usually short-term treatments and are less commonly prescribed because they carry some additional risks. For example, teens may grow dependent on them, and benzodiazepines may be misused. Stopping them suddenly could also lead to withdrawal symptoms or even seizures.
Other Medications
Occasionally, physicians may prescribe other medications to treat anxiety. This might include prescribing drugs such as antihistamines, non-SSRI antidepressants, hydroxyzine, or atypical antipsychotics. The exact medication prescribed can vary based on the teen’s diagnosis, the severity of the anxiety, and other factors.
Side Effects of SSRIs and SNRIs
Many teens don’t experience side effects when taking SSRIs or SNRIs. Those that do often find that the effects are mild and usually go away within the first few weeks of treatment. The most common side effects of SSRI and SNRI anxiety medications for teens include:
DizzinessDry mouthExcessive sweatingHeadacheNausea
Other possible side effects may include:
Changes in sexual functionConstipationInsomniaLoss of appetiteTiredness
Parents and physicians should discuss potential side effects with teens so they know what to expect and can report any side effects they are experiencing. If one medication isn’t working or causing serious side effects, your teen may need to change medications.
FDA Warnings
The Food and Drug Administration (FDA) issued a warning in 2004 that antidepressant medications often used to treat adolescent anxiety (such as many SSRIs and SNRIs) may increase suicidal thoughts and behavior in a small number of children and adolescents. No suicides were reported in the studies that led to the warnings. However, in clinical trials, the rate of suicidal thinking or suicidal behavior was 4% among patients receiving an antidepressant compared with 2% receiving a placebo. Research shows that warnings against antidepressant use for teens may have actually backfired. Prior to the FDA warnings (1990-2002), suicide deaths decreased substantially. Following the warnings (2005-2017), there was an abrupt decline in treatments, yet suicide deaths increased markedly. To address this concern, a black box warning was added to these medications. Critics of this warning fear that some children and teens may not get the help they need for fear that the medications are unsafe. To combat the added risk for adolescents, parents and teens are educated about the potential risks, and teens are monitored closely with frequent appointments.
A Word From Verywell
If your teen is struggling with anxiety, consult a healthcare provider. Describe your concerns and ask about treatment options. While some primary care physicians and pediatricians feel comfortable prescribing anti-anxiety medications to teens, others may refer children and adolescents to a psychiatrist. For more mental health resources, see our National Helpline Database. Psychiatrists are specialist physicians who treat mental health disorders. If you have concerns about your teen’s diagnosis or treatment plan, seek a second opinion. Talking to another professional can help you decide on the best course of action. Always educate yourself about any medications your child is taking. Read the handouts, ask questions, and talk to the prescribing doctor and pharmacist. Monitor your teen’s compliance with taking the medication, and make sure they’re taking it as prescribed. Skipping doses or doubling up on pills could be harmful. Attend your teen’s appointments. Talk to the doctor about any concerns you have and learn about your teen’s progress. With the right treatment and monitoring, teens can find relief from anxiety.
