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After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Medications Used After a Stroke

After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Here’s what to know about stroke causes and medications commonly prescribed during recovery.

A stroke disrupts the flow of blood and oxygen to the brain, potentially damaging brain tissue. This can lead to impaired speech, impaired cognitive function, memory loss, numbness, and paralysis.

Strokes can be life-threatening, so it’s important to seek immediate medical care if you exhibit signs of a stroke such as the following:

Sudden numbness or weakness in the face, arm, or leg

Sudden confusion or difficulty speaking or understanding speech

Sudden severe headache without another cause

There are two types of strokes, with different underlying causes:

An ischemic stroke occurs when blood flow to the brain is blocked, often due to a blood clot or the accumulation of plaque in blood vessels. It is the more common type of stroke. Associated health risk factors include high cholesterol, atrial fibrillation, and diabetes.

A hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures, damaging brain cells as a result. Associated health risk factors include high blood pressure and aneurysms.

Additionally, a transient ischemic attack (TIA) — sometimes referred to as a ministroke — occurs when there is temporarily reduced or blocked blood supply to the brain, often as the result of a blood clot. Unlike ischemic and hemorrhagic strokes, a TIA does not result in permanent damage.

Many of the leading risk factors for a stroke are modifiable, including:

Aftercare may include management of these risk factors.

There are a variety of medication classes used during stroke recovery, including the following.

Since high blood pressure is a leading cause of hemorrhagic strokes, stroke recovery may involve the use of several types of blood pressure medications.

Beta blockers cause the heart to beat more slowly and less forcefully, lowering blood pressure. Commonly prescribed beta blockers include atenolol (Tenormin®), bisoprolol (Zebeta®), metoprolol tartrate (Lopressor®), metoprolol succinate (Toprol-XL®), acebutolol (Sectral®), and propranolol (Inderal®).

ACE inhibitors lower blood pressure by blocking production of a hormone called angiotensin II, which causes blood vessels to narrow. Commonly prescribed ACE inhibitors include benazepril (Lotensin®), enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Prinivil®, Zestril®), and ramipril (Altace®).

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart beats with less force. Commonly prescribed calcium channel blockers include amlodipine (Norvasc®), diltiazem (Cardizem CD®, Tiazac®), nifedipine (Procardia XL®), and verapamil (Calan SR®, Verelan®).

Diuretics lower blood pressure by helping the body get rid of excess sodium and water, reducing the volume of fluid in blood vessels. Commonly prescribed diuretics include chlorthalidone (Thalitone®, Tenoretic®, and Clorpres®), hydrochlorothiazide (HydroDiuril®, Microzide®, and Esidrix®), and indapamide (Lozol®).

Read Common Types of Blood Pressure Medications to learn more about these medications and potential side effects.

Anticoagulants interrupt the body’s natural blood clotting process to prevent new clots from forming and existing ones from growing. The following types of anticoagulants may be prescribed after an initial ischemic stroke.

Warfarin (Coumadin® and Jantoven®) prevents your liver from producing proteins that help form blood clots. It is taken orally as tablets. It has been associated with excessive bleeding in some individuals. Inform your doctor if you have a bleeding disorder so that they can prescribe an alternative.

Direct-acting oral anticoagulants (DOACs) directly block the blood’s ability to form new clots. Commonly prescribed DOACs include apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®).

Read How Anticoagulants Prevent Blood Clots From Forming to learn more about these medications and potential side effects.

Like anticoagulants, antiplatelets prevent blood clotting and may be used during recovery from an ischemic stroke. They prevent platelets from coalescing, targeting a particular step in the formation of blood clots. Clopidogrel (Plavix®) is a commonly prescribed antiplatelet during stroke recovery.

Aspirin may also be used for antiplatelet therapy. If you are taking aspirin, avoid taking other nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen, as they may interfere with aspirin’s antiplatelet effect.

Atrial fibrillation, or Afib, is a rapid heart rate caused by irregularities in the heart’s upper chambers. It can lead to the accumulation of blood and the formation of blood clots, increasing an individual’s risk for stroke. (Having other conditions such as high blood pressure, diabetes, or heart failure in addition to Afib may further increase your risk for a stroke.)

There are several medications that may be used to control heart rate and prevent a secondary stroke, including beta blockers, calcium channel blockers, and an antiarrhythmic called digoxin (Digox®, Lanoxin®, Digitek®).

Since high cholesterol may be associated with an increased risk for an ischemic stroke or ministroke, statins — a type of cholesterol-lowering medication — may be prescribed during stroke recovery. Statins act on the liver to reduce the amount of cholesterol produced by your body, in turn preventing plaque accumulation.

Commonly prescribed statins include atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin (Mevacor®, Altoprev®), pravastatin (Pravachol®), rosuvastatin calcium (Crestor®), and simvastatin (Zocor®).

Read How to Manage High Cholesterol: Diet, Medications, and More to learn more about these medications and potential side effects.

If you have diabetes, your doctor may revisit your diabetes treatment plan after an ischemic stroke. Individuals with type 1 diabetes require insulin every day to maintain healthy blood sugar levels. Treatment for type 2 diabetes is more varied and may involve insulin, oral medications such as metform, or a combination of both.

A stroke may lead to the loss of bone density. This can increase an individual’s risk for osteoporosis, a condition that weakens bones. After a stroke, your doctor may recommend increasing your intake of calcium and vitamin D — the most important nutrients for bone strength and health — depending on your symptoms.

Treatment for osteoporosis may also include medications such as bisphosphonates, which prevent the loss of bone mass. Commonly prescribed bisphosphonates include alendronate (Fosamax®, Binosto®), ibandronate (Boniva®), risedronate (Actonel®, Atelvia®), and zoledronic acid (Reclast®).

Many individuals experience depression after a stroke, both as a response to the emotional challenges of stroke recovery and due to stroke-induced biochemical changes in the brain.

Medication may be necessary to manage symptoms of depression. There are many types of antidepressants, including:

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac®), sertraline (Zoloft®), citalopram (Celexa®), and escitalopram (Lexapro®)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta®), venlafaxine (Effexor®), and desvenlafaxine (Pristiq®)

Atypical antidepressants such as trazodone, mirtazapine (Remeron®), and bupropion (Wellbutrin®)

A psychiatrist can recommend the best option based on your particular symptoms of depression, your overall health history, and other medications you’re taking.

Recovery from a stroke is often a gradual process. In addition to taking medication and practicing a healthy lifestyle, your doctor may also recommend speech therapy, physical therapy, and/or occupational therapy.

It’s important to take care of your emotional and mental health. Speak with your healthcare provider about resources that can support your recovery and help you adjust to the changes a stroke may bring. Individual psychotherapy or support groups can be helpful tools.

At Alto, we make it as simple as possible to follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time through in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

A healthy pregnancy begins well in advance of trying to conceive. Preconception health planning sets you up to feel your best while growing a baby, allowing you to work towards health goals and manage preexisting conditions that could potentially result in complications.

How to Have the Healthiest Pregnancy Possible

It can also help you make any necessary changes to your treatment plan — for example, if you take a medication that is considered unsafe during pregnancy, your doctor can help you safely transition to an alternative.

Below, we break down some of the most important steps to take as you focus on your health and wellness while building or growing your family.

1. Consult your doctor about your health history

As you begin to plan for a baby, schedule a doctor’s appointment to identify any health issues that can impact pregnancy — whether it’s your first, second, third, or fourth.

While chronic health conditions like diabetes, hypertension, thyroid disease, and asthma are sometimes linked to pregnancy complications, you can prevent health challenges during pregnancy by staying proactive about treatment. For those with diabetes, this means working with your provider to maintain healthy blood sugar levels before trying to conceive. The same goes for hypertension and blood pressure levels.

Read Navigating Pregnancy With Type 1 or Type 2 Diabetes

Be sure to discuss any past pregnancy complications, if relevant. Experiencing certain complications in a first pregnancy can increase your risk of having them again in a later pregnancy. These complications include:

This does not mean that a recurrence is inevitable. Proactively managing your risk before and during pregnancy is the most important thing you can do to prevent these complications.

You should also share any health issues that you experienced during postpartum, including mental health challenges.

Changing a medication regimen or treatment plan

A pre-pregnancy care checkup is also an opportunity to discuss potential changes to your treatment plan. Bring all medications you are currently taking with you to this appointment, including vitamins and herbal remedies.

Never stop taking a prescribed medication without first consulting your doctor. Many medications cannot be abruptly discontinued and require you to slowly titrate, or taper off, over a period of time

It is recommended to focus on preconception health at least three months prior to pregnancy. However, everyone has unique health needs, and you may need more time to prepare for a healthy pregnancy. Try, as much as possible, to be patient and give your body the time and space it needs.

2. Get all recommended vaccines and screenings

At the beginning of your family building journey, ask your doctor which vaccines are recommended for your age. Certain infections or illnesses can cause birth defects or pregnancy complications. Many of these can be prevented with vaccines. And since illness-fighting antibodies can pass through the placenta, vaccinated individuals can pass along immunity to their growing baby in the womb.

It’s important to stay up to date since the recommended timing of vaccines varies. Not all can be given during pregnancy while others can. Your doctor can clarify which vaccines are recommended before pregnancy, during pregnancy, and after delivery. (Two of the most important vaccines for pregnant women, the flu vaccine and the Tdap vaccine (tetanus, diphtheria, pertussis), can be safely administered during pregnancy.)

Additionally, sexually transmitted infections (STIs) including HIV, HPV, and viral hepatitis can cause pregnancy complications and harm a developing fetus. Fortunately, treatment can prevent transmission to a baby. Screening for these infections is a critical step in planning for a healthy pregnancy.

3. Take steps to live your healthiest life

In the months before trying to conceive, revisit your health habits and make any changes to your routine or lifestyle that can support the healthiest pregnancy possible. There are several key areas to focus on.

Several nutrients are especially important to consume in the months before pregnancy. 

The American College of Obstetricians and Gynecologists recommends taking a prenatal vitamin with at least 400 micrograms of folic acid every day for at least a month before pregnancy through the first trimester. This important nutrient supports a baby’s growth and development and can prevent certain birth defects.

Depending on your health history and previous pregnancies, your provider may advise you to increase your intake of folic acid with an additional supplement.

(You can add prenatal vitamins to your next Alto delivery!)

Calcium helps build a developing fetus’s bones and teeth. Dairy products including milk, cheese, and yogurt are the primary sources of calcium, but you can also get this nutrient from other sources including:

If you are concerned about your calcium intake, ask your doctor about calcium supplements.

Iron also helps support a healthy pregnancy. Some prenatal vitamins include iron. It can also be found in the following iron-rich foods:

In addition, be sure to eat foods that support your body’s absorption of iron, including the following fruits and veggies, which are rich in vitamin A and beta-carotene:

If you have anemia, your doctor may recommend additional iron supplements.

An omega-3 fatty acid called DHA, or docosahexaenoic acid, is important for fetal growth and development. It can be found in some foods such as fatty fish. Depending on your diet, your doctor may recommend taking supplemental DHA before and during pregnancy and in the postpartum period. Some prenatal vitamins contain DHA, but not all, so be sure to check the ingredient list.

Since heavy caffeine consumption can affect fertility, it is recommended to reduce your intake to 200-300 mg per day.

Aim for about 150 minutes of moderate physical activity per week, incorporating some muscle-strengthening exercises.

Being underweight or overweight can cause health issues during pregnancy. Try to reach and maintain a healthy weight in the months before trying to conceive. Your provider is an important resource and can advise you on whether your weight may impact your pregnancy.

Smoking, drinking alcohol, and using certain drugs — including misusing prescription medication — can cause serious health issues during pregnancy like preterm birth and birth defects. When planning for a future pregnancy, do not be afraid to ask for any support needed to give up harmful behaviors. Your provider can offer resources. 

It’s also important to avoid secondhand smoke during pregnancy.

Genetics are a factor in your baby’s health and the progression of your pregnancy. Prior to pregnancy, discuss your family’s health history as well as your partner’s with your provider. This allows them to identify any genetic risk factors.

Some couples and individuals may be referred to a genetic specialist for reasons such as the following:

A family history of a genetic condition, birth defect, chromosomal disorder, or cancer

Two or more pregnancy losses or a stillbirth

Having given birth to a child with a genetic condition, birth defect, or intellectual disability

These risk factors do not guarantee that your baby will develop a health condition or that you will have a complicated pregnancy. Genetic testing can determine the likelihood of passing on a genetic issue to a child. A genetic specialist can help you understand your options for testing.

5. Prioritize your partner’s health as well

Preconception health concerns both parents. Male partners should also take steps to become as healthy as possible, which will improve their own reproductive health and fertility. This includes limiting their alcohol intake, quitting smoking or using harmful substances, and eating a healthy diet. (These lifestyle factors have been linked to issues with sperm production.)

Other important steps for male partners to take before trying to conceive include getting screened for STIs and consulting with a provider about family health history and medication use.

Alto Pharmacy can support you in preparing for a healthy pregnancy, however that looks for you. From delivering prenatal vitamins straight to your doorstep, supporting you in managing a chronic condition, or helping you navigate fertility treatment, we make it as simple as possible to focus on your health.

We offer free, same-day delivery and in-app medication management tools like reminders and auto refills. Additionally, our pharmacists are available to answer any questions you may have about medications or side effects.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

Despite the misconception of HIV as an illness that primarily affects young people, nearly half of all those with HIV in the U.S. are age 50 and older. This is both a testament to the effectiveness of treatment, as many of these individuals were diagnosed at an earlier age, and a reminder that people of all ages can receive an HIV diagnosis.

HIV and Aging: What to Know

As the HIV population ages, management of the condition continues to evolve, with different health challenges to navigate. Below, we highlight several important health considerations to be mindful of.

Antiretroviral therapy (ART) has been the frontline treatment for HIV since 1995. It is a combination of medications that keep HIV from replicating, stopping the progression of the virus and preventing transmission.

When all medications are taken every day as prescribed, ART can help those with HIV maintain an undetectable viral load. As a result, more than half of all individuals living with HIV in the U.S. are not at risk of transmitting the virus to others.

Regular attendance at doctor’s appointments is an important part of proactively managing HIV. Your provider needs to monitor your body’s response to your individual ART protocol, testing bone, kidney, metabolic, cardiovascular, cognitive, and liver function. (Thanks to the variety of medication options, it is easy to make adjustments as needed if you experience side effects or don’t achieve the desired results.)

For older adults with HIV, ongoing monitoring and testing is especially important, as there is a greater possibility of side effects such as impaired cognitive function and bone health issues.

It is also important to closely monitor how ART interacts with other medications. As you age, you are more likely to be prescribed multiple medications to manage several conditions.

People of all ages should be regularly tested for HIV, since a diagnosis is possible at any age. Older individuals are less likely to be tested — and more likely to receive a late diagnosis — due to the following factors:

The misconception of HIV as exclusively a young person’s illness

The overlap between HIV symptoms and typical signs of aging

Remember that getting tested is the only way to know your HIV status. Continue to stay proactive about regular testing every year. Search for an HIV testing site near you.

Older adults with HIV are more likely to also have health conditions associated with aging, including:

Here’s a quick look at how HIV intersects with several of these health issues.

The ongoing immune system activity and inflammation caused by HIV can contribute to plaque accumulation in blood vessels, a leading factor in the development of cardiovascular disease. Statins, a type of cholesterol-lowering medication, have been shown to lower the risk of heart disease in individuals with HIV.

To protect your heart health while living with HIV, stay on track with preventative care. Your provider should regularly check your cholesterol, blood pressure, and blood sugar. Additionally, maintain a heart-healthy lifestyle, with healthy habits like exercising regularly, eating a balanced diet, and refraining from smoking.

HIV has been linked to a greater risk of cancers including liver cancer, lung cancer, cervical cancer, and Hodgkin’s lymphoma. Ask your doctor about the recommended frequency of screenings for these types of cancer as well as others that are not related to HIV and AIDS.

The gradual loss of bone mass is a normal part of aging. For those with osteoporosis, a condition that weakens bones, the changes are more pronounced. HIV can increase a person's risk of developing osteoporosis. (While osteoporosis disproportionately affects women, both men and women with HIV face an increased risk.)

A simple bone mineral density test, sometimes referred to as a DEXA scan, can identify bone health issues. This screening is recommended for all women over the age of 65 and all men over the age of 70. If you have HIV, you may need earlier and/or more frequent screening. Consult with your doctor about recommended frequency.

Aging brings a risk of cognitive decline for anyone, regardless of health history. HIV has been linked to a faster decline in cognitive function. Though older individuals with HIV were once thought to have an elevated risk of dementia, the evolution of ART has helped lessen this possibility. However, a milder form of cognitive impairment called HIV-associated neurocognitive disorder (HAND) remains a health concern for older those with HIV.

Regular health exams should include screening for signs of cognitive issues including changes related to thinking or memory.

Loneliness and social isolation — factors in the development of physical health issues like dementia as well as mental health disorders — are more common among older adults. Older individuals with HIV should be even more proactive about monitoring mental health, as living with HIV at any age is linked to depression.

Make sure your doctor screens you regularly for depression and other mental health issues. If you have symptoms, ask about potential treatment options or a referral to a psychiatrist or psychologist. You may also want to explore additional resources such as virtual or in-person support groups for older adults with HIV.

Navigate HIV treatment with Alto by your side

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with antiretroviral therapy. We will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best option for your needs at the best price. To learn more, reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

Each October, American Pharmacist Month is an opportunity to not only celebrate the dedication of pharmacists and pharmacy technicians, but also to shine a light on all that they do.

National Pharmacists Month Spotlight: Gabrielle Kaplan

The average American visits a pharmacy 35 times a year, and the availability of pharmacists has the potential to address many gaps within healthcare, like access to the underutilized HIV prevention medication PrEP.

Many people who could benefit from the medication are unable to get a prescription from their primary care provider, whether it’s because they live too far from the doctor’s office or aren’t comfortable speaking about their sexual health. There's growing recognition that expanding the role of pharmacists in HIV prevention can help increase PrEP usage.

At Alto, we’re committed to maximizing the possibilities of pharmacy care. Not only do we divide our pharmacy roles into fulfillment and patient advocacy — we have numerous specializations under the umbrella of patient advocacy that allow our pharmacists to be part of the solution to precisely these healthcare challenges.

As part of our coverage of American Pharmacist Month, we spoke with Gabrielle Kaplan, a specialty patient care pharmacist who makes HIV prevention medication and treatment for complex chronic conditions more manageable for patients.

I’m a patient care pharmacist in our specialty department. We oversee medications that aren’t as common and which often have more side effects — or more serious side effects — including HIV medications, PrEP for HIV prevention, and injectable medications used to treat chronic conditions like psoriasis, rheumatoid arthritis, and high cholesterol.

The side effects associated with these medications can keep people from continuing with them. Since there’s a team of us whose sole focus is serving the patients who take these medications, they don’t just stop treatment. And they don’t have to worry about reaching out to us — we proactively check in. If anything is bothering them, we’ll take the initiative to call their provider and discuss their concerns.

What motivated you to focus on specialty pharmacy, specifically HIV treatment and prevention?

I was very interested in learning more about HIV treatment back in pharmacy school since a family member had passed away from it. The medications available today have drastically transformed what a diagnosis even means. I was excited by the possibilities, and it was always on my radar as a potential interest for the future. Working at Alto is the first time that I’ve been able to completely immerse myself in this specialization.

It’s a rapidly evolving area of both medicine and pharmacy, and there continues to be so much opportunity for pharmacists to take on a bigger role. In my state of Colorado, pharmacists can prescribe the HIV prevention medications PrEP and PEP. At Alto, we’re always discussing these updates and trying to expand the scope of what we offer patients and how we support their treatment.

What challenges have you encountered as a pharmacist?

By far the biggest pain point I experienced in retail pharmacy was staffing and having the number of pharmacists needed to execute all the day’s tasks while still providing great patient care.

Everyone working in a pharmacy is doing their very best, but there’s only so much we can do in an allotted time. It’s a disservice to patients and to those who work in the field — trying to balance the demands with your own mental well-being becomes nearly impossible.How do Alto’s pharmacy specializations make a difference for you and your patients?

Having a specific focus on patient care allows us to actually deliver quality patient care. At retail pharmacies where one pharmacist is doing it all, you’re trying to fill a prescription while on the phone and with someone yelling at you from across the room.

With fulfillment and patient advocacy separated at Alto, we are each able to focus on what’s in front of us at any given moment. For me, that means I can give patients my full and undivided attention and spend as much time with them as possible.

We have such a great team and plenty of support, so there’s no need to worry about other people’s tasks. We can each do the jobs that we’ve been specifically trained and are uniquely equipped to do.

What else is unique about Alto’s model?

The digital model makes it so that geography is less of an obstacle to care, and that each patient in our service areas has access to all of our resources. This is particularly relevant to my division of specialty pharmacy.

Many traditional retail pharmacies don’t have a specialty pharmacy in every physical location. Sometimes the specialty pharmacy is one centralized location from which everything is mailed. That means you won’t necessarily have a pharmacist in your local store who’s familiar with your medications and able to counsel you.

The medication used to treat or prevent HIV is complex, and it can be difficult to stay on track with treatment. The fact that any Alto customer taking these medications can talk to a pharmacist with deep expertise in that area of pharmacy makes a world of difference.

As a pharmacist, what does “care” mean to you?

It means always putting patients first — thinking about the care you would want a family member or friend to receive and delivering just that.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison.

Recognizing and Treating Anxiety, The Most Common Mental Health Disorder

Some degree of anxiety is natural. In fact, it can even be beneficial in certain contexts, like pre-interview butterflies. Other times, however, anxiety can become so debilitating that it interferes with daily life. Frequent and intense feelings of nervousness may be indicative of an underlying mental health disorder.

Anxiety disorders are the most common type of mental health disorder in the U.S., affecting more than 40 million adults, or about 19%. It is also estimated that 7% of children and adolescents between the ages of 3-17 struggle with symptoms of anxiety.

Over the past few years, as Covid-19 brings much upheaval and change, the number of Americans suffering from anxiety disorders and depression continues to increase. As a result, the U.S. Preventive Services Task Force is now recommending that all adults under the age of 65 be screened for anxiety. 

For many of those with an anxiety disorder, treatment — in the form of medication, psychotherapy, or both — is necessary to manage symptoms and maintain an active and fulfilling life. Below, we explain more about some of the most common treatment options.

Many factors can contribute to anxiety, including genetics, environment, behaviors, and situations. Common causes and risk factors include:

Having another mental health disorder such as depression

Genetics - having a relative with an anxiety disorder is considered a risk factor

Certain personality traits such as shyness

Individual experiences of anxiety can vary, so your anxiety symptoms may be different from those of a friend or family member with the condition. Anxiety can cause physical sensations like butterflies in your stomach or a racing heart. It can also bring an overall feeling of fear or unwanted thoughts.

Digestive issues, stomach pain, or nausea

Thoughts or flashbacks of a traumatic experience

Anxiety disorders are highly treatable with medication and therapy. (A combination of both is necessary for many people with an anxiety disorder.) While it can be difficult to share your feelings with a healthcare provider, it’s an important first step in managing symptoms.

These are some indications that you may benefit from treatment for anxiety:

Anxiety, fear, or worry has interfered with work and relationships

You find it difficult to control your anxiety, fear, or worry

You are concerned about your use of alcohol or other substances

There are many options for medication to treat anxiety. Some are used on a short-term basis or as needed while others are taken daily in the long term. Your provider will make recommendations based on your specific symptoms.

Though it can be frustrating, finding the right medication for your anxiety symptoms can take some trial and error.

There are several types of medications commonly used to treat anxiety disorders.

Benzodiazepines are sedatives that induce a feeling of calm. They amplify the effects of certain chemicals that act as a messenger between brain cells.

Benzodiazepines commonly prescribed for anxiety include:

These medications are typically used for short-term treatment of acute symptoms and may be prescribed on an as-needed basis. They often cause side effects like drowsiness and difficulty with balance and memory.

While benzodiazepines are effective, they have the potential for dependence and misuse. As a controlled substance under the U.S. Drug Enforcement Administration’s guidelines, there are tight regulations for prescribing and dispensing benzodiazepines.

Benzodiazepines are not safe to abruptly discontinue. If you have been taking a benzodiazepine for longer than two weeks, speak with your doctor about slowly tapering off to avoid withdrawal symptoms and lower the risk of seizure.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) increase a person’s levels of serotonin, a chemical in the brain that affects mood. Increased serotonin levels can alleviate symptoms of anxiety. These medications are considered a frontline treatment option for anxiety disorders and are also used to treat depression.

SSRIs commonly prescribed for anxiety include:

While SSRIs are very effective for many people with anxiety, it typically takes several weeks to experience their benefits. Even if you don't feel like the medication is working, continue to take it as prescribed so that you can achieve a therapeutic level. If you still have concerns several weeks into treatment, speak with your doctor.

Always consult your doctor before stopping an SSRI. It is not recommended to frequently start and stop SSRIs, and they should not be taken on an as-needed basis.

SSRIs have been linked to the following side effects, though they are mild in the majority of cases. Speak with your doctor about any concerns.

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) increase levels of serotonin — just like SSRIs — but they also increase norepinephrine, which boosts energy and focus. These medications may increase your energy levels in addition to alleviating symptoms of anxiety.

SNRIs commonly prescribed for anxiety include:

Venlafaxine extended-release (Effexor® XR)

There are additional medications used to treat anxiety that do not belong to the medication classes above.

The antihistamine hydroxyzine (Atarax®, Vistaril®) blocks histamine and boosts the effects of serotonin. As the only antihistamine that offers this effect, it is the only antihistamine used to treat anxiety. This is typically an option for those who experience side effects with SSRIs or SNRIs, or who have concerns about the addictive potential of benzodiazepines.

Buspirone (Buspar®) is another alternative to SSRIs and SNRIs. While it isn’t entirely understood how buspirone works, the medication likely activates certain areas of the brain to make serotonin more active.

Each person metabolizes medications differently. Open communication with your provider can help identify the medication that works best for you. Your doctor should know:

Any other medications you are prescribed and their dosages

Your experience of anxiety symptoms after taking the prescribed medication — do you feel like it’s working?

Medication for anxiety disorders is often combined with psychotherapy, which helps you understand and manage your emotional and behavioral responses to sources of anxiety.

Cognitive behavioral therapy (CBT) is considered one of the most effective types of therapy for anxiety disorders. It helps you recognize the underlying thoughts and behaviors that fuel uncomfortable or debilitating emotions. Shifting your thoughts and behaviors then alleviates symptoms of anxiety.

Finding the right therapist can take time. If you have insurance coverage of therapy sessions, check your insurance company’s provider network as a starting point. You can also look through reputable online databases like Psychology Today or the American Psychological Association (APA)’s psychologist locator. Some therapists offer sliding scale fees to make sessions more affordable.

Maintaining good mental health is easier with a reliable pharmacy on your side. Our pharmacists can answer any questions you may have about your medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

Blog

Medications Used After a Stroke

How to Have the Healthiest Pregnancy Possible

HIV and Aging: What to Know

National Pharmacists Month Spotlight: Gabrielle Kaplan

Recognizing and Treating Anxiety, The Most Common Mental Health Disorder

The Science of Habit-Forming

Managing Type 2 Diabetes at Any Age

Five Black Healthcare Leaders to Celebrate

Understanding Cystic Fibrosis

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