Over-the-Counter Anxiety Medication: What Are the Best Options

By Terez Malka, MD
Medically reviewed checkmarkMedically reviewed
July 19, 2022

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: 

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.

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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:

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.
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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.

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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.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.