What Medication Is Used for High Functioning Anxiety? A Pharmacological Overview

October 5, 2025 •

4 min read

An estimated 19.1% of U.S. adults have had an anxiety disorder in the past year [1.5.3]. For those wondering what medication is used for high functioning anxiety, the answer involves several classes of drugs often prescribed for formally diagnosed anxiety disorders [1.2.5].

Quick Summary

An overview of pharmacological treatments for high-functioning anxiety. This summary details first-line options like SSRIs and SNRIs, plus alternatives like beta-blockers for physical symptoms and buspirone for ongoing treatment.

Key Points

Not a Formal Diagnosis: 'High-functioning anxiety' is not a clinical term in the DSM-5, but its symptoms are real and treated similarly to diagnosed anxiety disorders like GAD [1.3.1, 1.3.4].
First-Line Medications: SSRIs and SNRIs are the most common, evidence-based, long-term medications prescribed for managing chronic anxiety symptoms [1.4.4, 1.2.5].
For Physical Symptoms: Beta-blockers like propranolol are highly effective for managing the physical manifestations of performance or situational anxiety, such as a racing heart or shaking [1.7.1].
Non-Addictive Alternative: Buspirone is an option for long-term treatment that is not associated with the dependence or sedation risks of other medication classes [1.8.4].
Use Benzodiazepines with Extreme Caution: Medications like Xanax and Ativan provide rapid relief but are intended for short-term use only due to a high risk of dependence, addiction, and withdrawal [1.9.2, 1.4.5].
Therapy is Key: Medication is most effective when paired with psychotherapy. Cognitive Behavioral Therapy (CBT) is a gold-standard treatment for anxiety [1.10.1, 1.10.5].
Consult a Professional: Deciding on a medication requires a thorough evaluation by a healthcare provider to determine the appropriate diagnosis and treatment plan [1.4.2].

Understanding 'High-Functioning Anxiety'

It is essential to understand that "high-functioning anxiety" is not a clinical diagnosis recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1.3.1, 1.3.2]. It's a colloquial term describing individuals who experience significant anxiety symptoms—such as persistent worry, fear of failure, overthinking, and restlessness—while still managing the demands of their daily and professional lives successfully on the surface [1.3.1, 1.3.3]. Internally, they may be struggling significantly [1.3.4]. Because it is not a formal diagnosis, treatment approaches, including medication, are based on symptoms that often overlap with recognized anxiety disorders like Generalized Anxiety Disorder (GAD) [1.3.4]. A healthcare professional must be consulted for an accurate diagnosis and personalized treatment plan [1.4.2].

First-Line Medications: SSRIs and SNRIs

Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are considered the first-line medication treatments for most anxiety disorders due to their effectiveness and safety profiles [1.4.2, 1.4.4, 1.2.5]. They are typically prescribed for long-term management rather than immediate relief [1.4.4].

SSRIs (Selective Serotonin Reuptake Inhibitors)

SSRIs work by increasing the levels of serotonin, a neurotransmitter that plays a role in mood regulation, in the brain [1.6.2]. By blocking the reabsorption (reuptake) of serotonin, more of it is available, which can help improve mood and reduce anxiety [1.6.1]. These medications can take four to six weeks to become fully effective [1.2.1].

Common Examples: Escitalopram (Lexapro), Sertraline (Zoloft), Paroxetine (Paxil), and Fluoxetine (Prozac) [1.2.5, 1.4.5].
Benefits: They have a strong safety profile and are effective for many people [1.2.1].
Potential Side Effects: Common side effects can include nausea, headaches, diarrhea, and sexual dysfunction, though these often diminish over time [1.2.1, 1.6.2].

SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)

SNRIs function similarly to SSRIs but also block the reuptake of norepinephrine, another neurotransmitter involved in the body's stress response and alertness [1.6.1, 1.6.5]. This dual action can be beneficial, especially if the person also experiences low energy [1.6.2].

Common Examples: Venlafaxine (Effexor XR) and Duloxetine (Cymbalta) [1.2.3, 1.2.5].
Benefits: Effective for both anxiety and certain types of chronic pain [1.6.3].
Potential Side Effects: Similar to SSRIs, but can also include increased blood pressure, sweating, and dry mouth [1.6.2, 1.6.3].

Other Prescribed Medications

Depending on the specific symptoms and needs of the individual, doctors might prescribe other classes of medication.

Beta-Blockers

Beta-blockers work by blocking the effects of adrenaline, which helps control the physical symptoms of anxiety like a racing heart, sweating, and trembling [1.7.1, 1.7.4]. They are particularly effective for situational or performance anxiety—a common trait in those with high-functioning anxiety [1.7.1].

Common Example: Propranolol (Inderal) [1.7.3].
Benefits: They are fast-acting, non-sedating, and not habit-forming [1.7.1]. This makes them suitable for 'as-needed' use before a stressful event like public speaking [1.2.1].
Limitations: They do not address the psychological aspects of anxiety, such as worry or racing thoughts [1.7.1].

Buspirone (BuSpar)

Buspirone is an anti-anxiety medication that works differently from other classes by affecting serotonin and dopamine receptors [1.8.4]. It is used for ongoing treatment and takes several weeks to become effective [1.8.1, 1.8.3].

Benefits: It is not associated with sedation or dependence, making it a safer long-term option compared to benzodiazepines [1.8.4]. It can help reduce worry and allow for clearer thinking [1.2.1].
Potential Side Effects: Dizziness, nausea, and headaches are common side effects [1.8.3].

Benzodiazepines (Short-Term Use Only)

Benzodiazepines are highly effective sedatives that provide rapid relief from acute anxiety symptoms [1.2.1]. However, their use is strictly limited to the short term (typically 2-4 weeks) [1.2.2].

Common Examples: Alprazolam (Xanax), Lorazepam (Ativan), and Diazepam (Valium) [1.2.4].
Major Risks: Long-term use leads to a high risk of tolerance, physical dependence, addiction, and severe withdrawal symptoms [1.9.1, 1.9.2]. Abruptly stopping can be dangerous [1.9.1]. For these reasons, they are not a first-choice or long-term solution [1.4.5].

Comparison of Anxiety Medications


Medication Class	How It Works	Best For	Key Considerations
SSRIs	Increases serotonin levels in the brain [1.6.2].	Long-term management of general worry and mood symptoms [1.4.5].	Takes 4-6 weeks to work; some initial side effects possible [1.2.1].
SNRIs	Increases serotonin and norepinephrine levels [1.6.1].	Long-term management, especially with co-occurring low energy or pain [1.6.2].	May increase blood pressure [1.6.3].
Beta-Blockers	Blocks adrenaline to reduce physical symptoms [1.7.1].	Situational/performance anxiety (e.g., public speaking) [1.7.5].	Does not treat psychological symptoms of anxiety [1.7.1].
Buspirone	Affects serotonin and dopamine receptors [1.8.4].	Ongoing, long-term anxiety management without sedation [1.8.4].	Takes several weeks to become effective; not for acute relief [1.8.3].
Benzodiazepines	Enhances the effect of GABA to produce a calming effect [1.4.5].	Short-term, rapid relief of severe, acute anxiety or panic [1.2.1].	High risk of dependence and addiction; for short-term use ONLY [1.9.2].

Beyond Medication: The Role of Therapy

Medication is often most effective when combined with psychotherapy [1.7.1]. Cognitive Behavioral Therapy (CBT) is considered a first-line treatment for anxiety disorders [1.10.1]. CBT helps individuals identify, challenge, and change the unhelpful thought patterns and behaviors that maintain anxiety [1.10.3]. It often includes techniques like cognitive restructuring (reframing anxious thoughts) and exposure therapy (gradually facing feared situations) to build coping skills and resilience [1.10.1, 1.10.2].

Conclusion

While "high-functioning anxiety" isn't a formal diagnosis, the distressing symptoms are very real and treatable. The primary medications used are typically first-line treatments for diagnosed anxiety disorders, such as SSRIs and SNRIs for long-term management [1.4.4]. Other options like beta-blockers can target specific physical symptoms of performance anxiety, while buspirone offers a non-addictive long-term alternative [1.7.1, 1.8.4]. Benzodiazepines are reserved for short-term, acute situations due to significant risks [1.9.2]. A comprehensive treatment plan, developed with a healthcare professional, often combines medication with therapy like CBT for the most effective and lasting results [1.10.5].

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.

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Frequently Asked Questions

While 'high-functioning anxiety' isn't a formal diagnosis, a doctor can prescribe medication based on your symptoms, which often align with diagnosed anxiety disorders like GAD. Common prescriptions include SSRIs or SNRIs [1.3.1, 1.4.2].

Selective Serotonin Reuptake Inhibitors (SSRIs) are considered the first-line medication for many forms of anxiety due to their effectiveness and safety profile [1.4.5, 1.2.5].

Yes. SSRIs, SNRIs, beta-blockers, and buspirone are not considered addictive and are prescribed for both short-term and long-term management of anxiety [1.7.1, 1.8.4, 1.6.2].

Antidepressants like SSRIs and SNRIs typically take four to six weeks to build up in your system and reach their full therapeutic effect [1.2.1, 1.2.5].

Beta-blockers, such as propranolol, are often prescribed for performance or situational anxiety because they quickly reduce physical symptoms like a racing heart and trembling without causing drowsiness [1.2.1, 1.7.1].

SSRIs (e.g., Zoloft) are for long-term management and take weeks to work, while benzodiazepines (e.g., Xanax) are sedatives that offer immediate, short-term relief but carry a high risk of dependence [1.4.5, 1.9.1].

Not always. For some, psychotherapy like Cognitive Behavioral Therapy (CBT) and lifestyle changes are very effective. Medication is a tool that is often used in combination with therapy, and the decision should be made with a healthcare provider [1.10.3, 1.10.5].