What shot do they give you for anxiety? Understanding injected medications for severe anxiety

October 7, 2025 •

4 min read

An estimated 30% of adults will experience an anxiety disorder at some point in their lives, but injected medications are typically reserved for severe, acute episodes requiring rapid symptom control. The answer to "What shot do they give you for anxiety?" is not a single medication but a range of options, primarily used in emergency or specialized clinical settings, depending on the severity and cause of the anxiety.

Quick Summary

Injected medications for anxiety are used for urgent symptom control, not routine treatment. Benzodiazepines like lorazepam and midazolam are common in emergencies. Specialized injections such as ketamine and stellate ganglion block are used for specific conditions like treatment-resistant anxiety and PTSD.

Key Points

Not a single shot: There is no universal "shot for anxiety"; rather, different injectable medications are used for specific, severe anxiety cases.
Emergency use: Benzodiazepines such as lorazepam (Ativan) and midazolam (Versed) are common injections for rapidly calming acute anxiety and agitation in emergency settings.
Specialized therapies: For treatment-resistant anxiety, specialized injections like intramuscular (IM) ketamine therapy are sometimes used in a clinic, not an emergency room.
PTSD-related anxiety: The stellate ganglion block (SGB), an anesthetic injection, is used for severe anxiety symptoms related to PTSD by calming the sympathetic nervous system.
Lower-risk alternative: Hydroxyzine, an antihistamine with sedative properties, can be given by injection for anxiety or procedural sedation and carries a lower risk of dependence compared to benzodiazepines.
Close medical supervision: All anxiety injections are powerful medications that require close monitoring by medical professionals due to their potential side effects and risk profiles.

Injections for Anxiety: The Context

Injections for anxiety are not a routine treatment for managing generalized anxiety disorder. Instead, they are reserved for specific, severe, or emergency circumstances. The primary scenarios include acute agitation or severe panic in a hospital setting, sedation before a medical procedure, and specialized therapies for treatment-resistant conditions. The route of administration (e.g., intramuscular or intravenous) is chosen for its rapid onset of action, which is necessary when a patient is in immediate distress or unable to take oral medication.

Emergency Injections: Benzodiazepines

Benzodiazepines are a class of central nervous system (CNS) depressants that are frequently used for rapid tranquilization in emergency settings. They enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA), which results in a calming, sedative effect. The quick action is critical for de-escalating dangerous or highly distressing situations.

Key benzodiazepines available as injections include:

Lorazepam (Ativan): Often administered intramuscularly (IM) or intravenously (IV) for acute agitation, severe panic attacks, or status epilepticus. It is well-studied for emergency use and is one of the most common injections used in psychiatric emergency settings.
Midazolam (Versed): A fast-acting benzodiazepine that can be given IM or IV. It is frequently used for procedural sedation and to relieve anxiety before surgery, as it causes drowsiness and can create amnesia for the procedure. In some emergency cases, it is used for rapid tranquillization of agitated patients.
Diazepam (Valium): Available as an injection, it can be used for acute anxiety symptoms, severe agitation, and alcohol withdrawal. It has a longer duration of action compared to midazolam.

These medications are powerful and carry significant risks, including sedation, respiratory depression, and dependence with repeated use. Their use is carefully managed under close medical supervision.

Other Injected Medications

While benzodiazepines are the most common injections for immediate anxiety relief, other medications are used for specific or treatment-resistant cases. This highlights that there is no single "shot" but a variety of pharmacological tools.

Hydroxyzine (Vistaril)

This is an antihistamine with sedative properties that can be administered via intramuscular injection. It is used to help control anxiety and tension, including before and after surgery. Unlike benzodiazepines, hydroxyzine is not habit-forming, making it an alternative for patients with concerns about dependence. It works by decreasing activity in the brain and blocking histamine.

Ketamine

Originally an anesthetic, ketamine has shown rapid-acting and sustained results for treatment-resistant depression and anxiety. Intramuscular (IM) ketamine is one route of administration for this specialized therapy, which is offered by clinics and is not an emergency room solution for typical anxiety. It works by modulating neurotransmitter systems in the brain, including blocking NMDA receptors and promoting new neural connections. Its use is closely monitored due to potential side effects like hallucinations and changes in blood pressure.

Stellate Ganglion Block (SGB)

This is a nerve block injection of a local anesthetic targeting the stellate ganglion nerves, which are part of the sympathetic nervous system in the neck. SGB has been used to treat anxiety symptoms associated with post-traumatic stress disorder (PTSD). It works by numbing the nerves, which can reset or calm the fight-or-flight response, reducing anxiety signals sent to the brain. The effects of a single injection can last for months or years in some individuals.

Comparison of Injection Types


Feature	Emergency Benzodiazepines	Hydroxyzine	Ketamine	Stellate Ganglion Block (SGB)
Purpose	Rapidly control acute, severe anxiety, agitation, or panic.	Mild-to-moderate anxiety, procedural sedation, or when dependence is a concern.	Treatment-resistant depression and anxiety, often after other therapies fail.	PTSD-related anxiety symptoms by resetting the sympathetic nervous system.
Onset	Fast (minutes to 30 minutes, depending on route).	Faster than oral, but generally slower than IM benzodiazepines.	Fast (minutes, depending on route).	Within 30 minutes for initial effects.
Duration	Intermediate-acting (hours).	Variable; can provide several hours of sedation.	Short-term effects post-injection (minutes to hours), but can have sustained therapeutic effects.	Can provide long-lasting relief (months to years).
Setting	Hospital emergency department or inpatient setting.	Hospital, clinic, or specialized office.	Specialized psychiatric clinics.	Specialized pain or spine clinic.
Dependence Risk	Significant risk with repeated use.	Low risk.	Concerns related to misuse and abuse.	None reported.

The Role of Injectable Medications in Modern Anxiety Treatment

Injected anxiety medication is not a substitute for comprehensive, long-term anxiety management, which typically involves oral medications (like SSRIs or non-habit-forming anxiolytics) and psychotherapy. Injections fill a vital, but limited, role. For instance, in an emergency department, a severely agitated patient may need rapid tranquilization with a benzodiazepine to prevent harm to themselves or others. A person preparing for a surgical procedure may receive a benzodiazepine injection to relieve anxiety and cause sedation, providing a smoother experience.

For conditions that have not responded to standard treatments, newer injected therapies offer hope. Intramuscular ketamine is a rapidly emerging option for treatment-resistant anxiety and depression, administered under strict clinical supervision. A stellate ganglion block provides a non-medication-based approach for targeting the physiological symptoms of PTSD-related anxiety.

Conclusion

While the concept of a quick "shot for anxiety" is compelling, it's crucial to understand that such treatments are not a simple fix for everyday anxiety. Instead, they are specialized tools in a clinician's arsenal, reserved for serious and specific situations. Benzodiazepines like lorazepam and midazolam serve as powerful, fast-acting sedatives in emergencies, while treatments like intramuscular ketamine and stellate ganglion blocks address specific, often treatment-resistant, conditions. The appropriate choice of medication and administration method depends entirely on the patient's condition, the severity of the symptoms, and the clinical setting. The use of any injectable medication for anxiety should only be done under the care and supervision of a qualified medical professional.

For more in-depth information on injectable ketamine for mental health conditions, consult reliable medical sources such as the National Institutes of Health.(https://pmc.ncbi.nlm.nih.gov/articles/PMC8974191/)

Frequently Asked Questions

No, injectable anxiety medication is not used for managing regular or everyday anxiety. It is reserved for severe, acute episodes that occur in emergency or controlled clinical settings under the direct supervision of a doctor.

The most common injections used for acute anxiety or agitation in an emergency room are fast-acting benzodiazepines like lorazepam (Ativan), midazolam (Versed), and diazepam (Valium).

Emergency anxiety shots, particularly benzodiazepines administered intravenously or intramuscularly, can work very quickly, sometimes within minutes, to provide rapid sedation and relief.

Some specialized injections, like ketamine therapy or a stellate ganglion block (SGB), are administered in specific clinics or outpatient settings for chronic or treatment-resistant conditions. However, emergency injections are strictly given in a hospital or emergency department.

Yes. While emergency benzodiazepine injections carry a risk of dependence, other options like hydroxyzine (an antihistamine) and stellate ganglion block injections are not associated with this risk.

Risks depend on the medication. Benzodiazepine injections can cause significant sedation and respiratory depression. Ketamine carries risks of hallucinations and blood pressure changes. Hydroxyzine can cause drowsiness and confusion.

For severe panic attacks or panic disorder, benzodiazepines can be effective, but they are typically used short-term due to the risk of dependence. A doctor will determine if an injection is appropriate based on the severity of the attack and patient history.