# Medication for Depression and Anxiety: What Treats Both

> Medication for depression and anxiety often starts with one SSRI or SNRI. Learn the add-ons, older options, time to work, safety warnings and why therapy helps.

URL: https://foundationmedicalgroup.org/medication-for-depression-and-anxiety/
Published: 2026-11-05
Updated: 2026-11-05

For many adults who have both depression and anxiety, one medication can treat both. An SSRI or SNRI antidepressant is the usual first choice. If anxiety stays, a prescriber may add buspirone or, for a short time, a benzodiazepine. Most antidepressants take 4 to 8 weeks to work fully, and therapy such as CBT often helps the medicine work better.
What Is the Best Medication for Depression and Anxiety? Medication for depression and anxiety means prescription drugs that act on a depressive disorder and an anxiety disorder at the same time. Is there one best medicine? Honestly, no. Bodies respond differently, and you may need to try two or more medicines before one works well for you. That’s frustrating to hear when you just want to feel better, but it’s normal.
What there is, is a usual first step. A 2023 primary care review notes that 45.7% of people with lifetime depression also have one or more anxiety disorders, so prescribers often look for one medicine that covers both. The National Institute of Mental Health (NIMH) says SSRIs and SNRIs are commonly prescribed because they improve symptoms across a broad group of depressive and anxiety disorders. They also have fewer side effects than older antidepressants. Starting with one medicine keeps the plan simple. And it’s easier to tell what’s helping.
Not sure which condition you’re dealing with? Our guide to anxiety vs depression explains how the two differ. This page picks up once you and a prescriber decide medicine is part of the plan. That ongoing work, from the first prescription through every dose change, is what medication management covers.
Why Does Comorbid Anxiety Change the Choice of Antidepressant Medication? Comorbid anxiety means anxiety that occurs alongside depression. It matters for three reasons.
First, it can make treatment harder. In the large STAR*D trial, depressed patients with comorbid anxiety were less likely to reach remission and more likely to have side effects than people with depression alone. The 2023 CANMAT guideline update links depression with anxious distress to a poorer response to standard treatments. But it found no evidence that any one medicine works better, so all first-line antidepressants are recommended for it.
Second, some antidepressants are activating. Extra energy can help depression, yet someone with anxiety may feel it as restlessness, more anxiety or even panic. The review names bupropion, fluoxetine and venlafaxine as the most activating. It says they may be dosed cautiously for people with a history of anxiety or panic.
Third, the diagnosis has to be right. The same review says people with depressive symptoms should be screened for a past manic or hypomanic episode, because an antidepressant on its own isn’t appropriate for bipolar disorder. Expect your prescriber to ask about this.
Beyond that, our prescribers look at what has worked for you or a close relative before. They also weigh your sleep and appetite, the other prescription medicines you take, and which side effects you most want to avoid.
What Is the Most Common Antidepressant Prescribed for Anxiety? SSRIs are the most common starting point for anxiety and for depression. A selective serotonin reuptake inhibitor (SSRI) and a serotonin norepinephrine reuptake inhibitor (SNRI) share one main action: they block the reuptake of serotonin, a brain messenger. SNRIs also act on norepinephrine. Common SSRIs include sertraline, escitalopram, fluoxetine and paroxetine; common SNRIs include venlafaxine and duloxetine, as listed on the FDA guide to depression medicines.
The NIMH says that for panic disorder and social anxiety disorder, providers typically start with SSRIs or other antidepressants because they have fewer side effects than other medicines. For generalized anxiety disorder, the review notes that escitalopram, paroxetine, duloxetine and venlafaxine are FDA approved. Outcomes between antidepressant classes are fairly equal, so an SSRI may be preferred first because it’s usually well tolerated.
Within the SSRI and SNRI classes, differences between drugs are small. Still, two people can respond quite differently to two drugs in the same class. So a first choice is a starting point, not a final answer. For anxiety on its own, drug by drug, see our anxiety medication guide.
Atypical Antidepressant Options: Bupropion, Mirtazapine and Vortioxetine An atypical antidepressant is a newer medicine that doesn’t fit the SSRI or SNRI groups. Along with SSRIs and SNRIs, bupropion, mirtazapine and vortioxetine are considered first-line options for major depression. Each has a different profile, so the choice depends on your symptom mix.
Bupropion may help people with only a partial response to an SSRI, people with sexual side effects from another antidepressant, or someone who wants support to quit smoking. The review also says it may not be the best fit with comorbid anxiety or insomnia. Anyone with a current or past eating disorder such as bulimia or anorexia should avoid it. Mirtazapine may help with insomnia, agitation, low appetite or ongoing stomach upset. It can cause significant weight gain (welcome for some, a problem for others). The review also lists it as effective for reducing anxiety symptoms. Vortioxetine may help people who didn’t respond to antidepressants that work in other ways, and it may cause less sexual dysfunction. Nausea and constipation can be marked. The same review lists a fourth drug, vilazodone, as possibly having particular benefits for people with depression and anxiety together. None of these is ranked above the others. Your prescriber weighs them against your history.
Anti Anxiety Medications Added to an Antidepressant Sometimes the antidepressant lifts mood but anxiety lingers. Then a prescriber may add an anti anxiety medication rather than start over.
Buspirone is the most common add-on of this kind. It isn’t a benzodiazepine, it isn’t a controlled substance, and it isn’t habit forming. The review describes it as an add-on for a partial response to an SSRI or SNRI, or as a stand-alone option for people who can’t tolerate those drugs. It’s FDA approved for generalized anxiety disorder and isn’t expected to cause sexual side effects or weight gain.
Here’s the part people miss: buspirone isn’t an as-needed pill. The NIMH says buspirone must be taken every day for 3 to 4 weeks to reach its full effect, and it doesn’t work for anxiety on an as-needed basis. Some effect may show within 1 to 2 weeks.
Other anxiety treatments, such as beta blockers for physical symptoms in specific situations, are covered in our anxiety medication guide.
Are Benzodiazepines Safe for Depression and Anxiety? Benzodiazepines can reduce severe anxiety in the short term. They’re anti-anxiety medicines, not antidepressants, so they don’t treat the depression side. The NIMH says taking them over long periods may lead to tolerance or dependence. That’s why providers usually prescribe them for short periods and taper them slowly.
The FDA takes the risks seriously. In 2020 it required the Boxed Warning for all benzodiazepines to be updated to cover abuse, misuse, addiction, physical dependence and withdrawal reactions. The same notice reports about 92 million benzodiazepine prescriptions dispensed in the United States in 2019. That’s a surprising number. Physical dependence can develop when these medicines are taken steadily for several days to weeks, even as prescribed.
Stopping suddenly is risky. The FDA warns that stopping a benzodiazepine abruptly, or lowering the dose too fast, can cause serious withdrawal symptoms, including seizures. Withdrawal can bring anxiety, irritability, insomnia, tremors and panic attacks. Any change should follow a taper plan from your prescriber. Misuse can lead to overdose or death, especially when benzodiazepines are combined with opioid pain relievers, alcohol or illicit drugs.
The review notes that benzodiazepines eased anxiety about as much as SSRIs, SNRIs and buspirone in pooled studies, but were tolerated much worse. If one is prescribed, expect the lowest dose for the shortest time.
Tricyclic Antidepressant and MAOI Options When First-Line Drugs Fall Short Older antidepressants are still used. A tricyclic antidepressant, such as amitriptyline or nortriptyline, or a monoamine oxidase inhibitor (MAOI), such as phenelzine, causes more side effects than newer drugs. The NIMH says they may still be the best option for some people. MedlinePlus says a provider might suggest one if newer antidepressants don’t help.
These drugs need extra care:
The FDA lists low blood pressure and life-threatening irregular heartbeat among the warnings for tricyclics. MAOIs must not be taken with other depression medicines, or with central nervous system stimulants or depressants. On an MAOI you’ll need to avoid foods containing tyramine (aged cheese, wine, aged protein foods), and skip cold pills and decongestants too. Mixing an SSRI or SNRI with an MAOI can cause severe serotonin syndrome, so prescribers never combine them.
What if several medicines haven’t worked? The NIMH says treatment resistant depression may be diagnosed when symptoms don’t improve after at least two antidepressants. Our guide to treatment resistant depression covers next steps, and you can also ask about TMS for depression, a brain stimulation therapy we offer in person at our Richmond, Virginia clinic only.
Treatment Options Compared: Which Medication Class Fits Which Need The table compares medication classes by their role when both conditions are present. Think of it as a map for a talk with your prescriber, not a choice to make on your own.
Medication class Role when you have both depression and anxiety Time to full effect Main caution SSRIs (sertraline, escitalopram, fluoxetine, paroxetine) Usual first choice; treats both Usually 4 to 8 weeks Nausea, sleep changes, sexual side effects; under 25 watch for suicidal thoughts SNRIs (venlafaxine, duloxetine) First-line for both; option if an SSRI falls short Usually 4 to 8 weeks Venlafaxine can raise blood pressure; discontinuation symptoms if stopped fast Atypical antidepressants (bupropion, mirtazapine, vortioxetine) First-line for depression, picked by symptom mix Usually 4 to 8 weeks Bupropion may not suit prominent anxiety or insomnia; mirtazapine weight gain Buspirone (add-on) Added for anxiety after a partial response 3 to 4 weeks, taken daily Not for as-needed use Benzodiazepines (short term only) Short-term relief of severe anxiety; does not treat depression Ask your prescriber Boxed warning: abuse, addiction, dependence, withdrawal Tricyclics Option when newer drugs have not helped Usually 4 to 8 weeks More side effects; low blood pressure, heart rhythm MAOIs Option when newer drugs have not helped Usually 4 to 8 weeks Food and drug interactions; never with SSRIs or SNRIs Times for antidepressants come from the NIMH, which says antidepressants usually take 4 to 8 weeks to work. A class is only a starting point. Your prescriber chooses the medicine, and the dose, based on you.
How Long Does It Take Medication for Depression and Anxiety to Work? Longer than most people hope. The NIMH says antidepressants usually take 4 to 8 weeks to work, and problems with sleep, appetite, energy and concentration often improve before mood lifts. That early change is a good sign, even if you don’t feel better yet.
Prescribers watch for early improvement. The CANMAT guideline defines it as a drop of 20% or more in a symptom score within 2 to 4 weeks. No improvement in that window? The review says the dose is usually raised, or the medicine switched if side effects are a problem. In the STAR*D trial, the average time to remission ranged from 5.4 to 7.4 weeks across its 4 treatment steps.
Once symptoms are gone, treatment doesn’t stop right away. CANMAT, as cited in the review, recommends continuing for at least 6 to 9 months after remission, because stopping before 6 months is linked to higher relapse. Follow-up visits are where this happens: a dose change, a switch or an add-on. Wondering how long it takes antidepressants to work? That’s a fair question to bring to your first follow-up.
What Are the Common Side Effects of Taking Depression Medication? Not everyone gets side effects from depression medication. When they happen, they’re usually mild and may ease as your body adjusts. MedlinePlus lists the most common as nausea and vomiting, weight gain, diarrhea, sleepiness and sexual problems. The NIMH adds upset stomach and headache.
Drug interactions matter. Tell your prescriber about every prescription medicine, over-the-counter product, herb and supplement you take, plus alcohol and recreational drugs. The NIMH warns that combining antidepressants with other products that act on serotonin, such as triptans for migraine or St. John’s wort, can cause a rare but life-threatening illness called serotonin syndrome.
Don’t stop on your own. Stopping an antidepressant abruptly can cause discontinuation symptoms, especially after more than 6 to 8 weeks of use. The review says these symptoms usually start within 3 days and fade within 1 to 2 weeks. They’re more likely with short-acting drugs such as paroxetine and venlafaxine. Your prescriber can plan a slow taper.
For a closer look at specific effects, see our guide to SSRI side effects.
Safety Warnings: Suicidal Thoughts and When to Get Help All antidepressants carry a boxed warning about suicidal thoughts and behavior in young people. The NIMH says children, teenagers and young adults under 25 may have more suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks or after a dose change. People of all ages taking antidepressants should be watched closely, especially in the first few weeks of treatment.
Never stop a medicine or change a dose without your prescriber. Tell them about any problems you have, including thoughts about suicide.
If you or someone you know is struggling or having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, or chat at 988lifeline.org. In a life-threatening situation, call 911.
Pregnant, planning a pregnancy or recently gave birth? Tell your prescriber, because it changes which medicine fits. The same goes for postpartum depression treatment after birth.
Can You Take Medication for Depression and Anxiety With Therapy? Yes, and for many people the two work best together. The review says studies support combining an antidepressant with psychotherapy, especially cognitive behavioral therapy (CBT). The combination improves short-term and lasting response and lowers the risk of relapse compared with medicine alone. CANMAT reaches the same conclusion: combined treatment is more effective than either alone. For generalized anxiety disorder, the review notes that psychotherapy may be even more useful.
CBT helps you notice automatic thoughts that are inaccurate or harmful, question them, and change the behavior patterns they drive. For anxiety disorders, a type of CBT called exposure therapy helps a person learn to tolerate distress in brief, supported steps until the fear goes down. Even when medicine eases symptoms, the NIMH says therapy can help with specific problems like irrational fears or trouble coping at home or work.
At Foundation Medical Group, our therapists offer talk therapy by secure video in Virginia, Utah, Georgia and Texas, and in person at our Richmond, Virginia clinic. Your prescriber and therapist can share one plan.
How Can I Treat Depression Without Using Antidepressants? For mild to moderate depression, medicine isn’t the only first step. The review says either an antidepressant or psychotherapy may be an appropriate first treatment, depending on your preference and what’s available. It adds that CBT may be just as effective as antidepressants for some people. CANMAT also lists structured psychotherapy and antidepressants as the two options with the strongest evidence for a moderate episode.
For anxiety, the NIMH notes that evidence-based therapies such as CBT reduce symptoms of anxiety and depression. When medicines haven’t helped, brain stimulation therapy is another route. We offer TMS for depression at our Richmond, Virginia clinic.
Already on a medicine? Don’t stop it to try something else. Talk to your prescriber first, so any change is planned.
Medication Management for Depression and Anxiety at Foundation Medical Group Our medication management is ongoing prescribing by board-certified physicians and psychiatric nurse practitioners, focused on your mental health over time. Visits are usually monthly at first, then every 1 to 3 months once you’re stable. When a medicine falls short, we start with the usual next steps: a dose change, a switch, or an add-on.
Care starts with a psychiatric evaluation of up to 60 minutes. You don’t need a referral, and most patients are seen within 3 to 5 business days.
Where we see you:
In person: psychiatry and medication management at our clinics in Richmond, Virginia; American Fork, Utah; and Dallas, Texas. By video: telehealth in Virginia, Utah, Georgia and Texas, as long as you’re physically in one of those states during the visit. In Georgia, our psychiatric care is by video only. Some controlled medication starts need an in-person visit. That’s every place we see patients.
Insurance. We work with many plans. Common plans by state:
Virginia: Aetna, Anthem, Cigna, UnitedHealthcare, TRICARE, Virginia Medicaid and Sentara Health Plans. Call to confirm coverage. Our Richmond clinic doesn’t accept Medicare. Texas: Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, Humana, TRICARE, Medicare and Texas Medicaid. Call to confirm coverage. Utah: Aetna, Blue Cross Blue Shield and SelectHealth. Call to confirm coverage. Georgia: Cigna for now; other plans aren’t accepted there yet. Call to confirm coverage. Coverage varies by plan and state. Call our office at (800) 983-1974 to confirm your plan before your first visit.
Key Takeaways One SSRI or SNRI often treats both depression and anxiety and is the usual first step. Buspirone can be added for anxiety; benzodiazepines are for short-term use only. Antidepressants usually take 4 to 8 weeks to work fully. People under 25 need close watching in the first weeks; never stop a medicine on your own. Medicine plus therapy such as CBT often works better than either alone. FAQ Can one medication treat both depression and anxiety? Often, yes. SSRIs and SNRIs are commonly prescribed because they improve a broad group of depressive and anxiety disorders, so one medicine can cover both. Some people still need a second medicine for anxiety, a switch to another antidepressant, or therapy alongside the medicine. Your prescriber builds the plan around your own symptoms.
Is buspirone or a benzodiazepine better to add for anxiety? They work in different ways. Buspirone is taken every day, is not habit forming and can take 3 to 4 weeks to reach its full effect. Benzodiazepines act on short-term anxiety, but they carry an FDA boxed warning for abuse, addiction, dependence and withdrawal, so prescribers keep them short. Which fits you is your prescriber’s call.
What should I do if my antidepressant is not working after 8 weeks? Tell your prescriber rather than stopping on your own. The next step is often a dose change, a switch to another medicine or an add-on. Your prescriber may also take a second look at the diagnosis. When at least two antidepressants have not helped, it may be treatment resistant depression, which has its own options.
Can I get medication for depression and anxiety by telehealth? Yes, in Virginia, Utah, Georgia and Texas, as long as you are physically in one of those states during the video visit. Routine medication management works well by video. For some controlled medications, such as benzodiazepines, the first visit needs to be in person, and in Georgia our care is by video only.
Do I need a referral to see a psychiatrist for medication? No. You can book a psychiatric evaluation without a referral. The first visit runs up to 60 minutes with a board-certified psychiatrist or psychiatric nurse practitioner, and most patients are seen within 3 to 5 business days. You leave with a working diagnosis and a plan, which may include medication.
Sources Journal for Nurse Practitioners (PMC), Pharmacotherapy for Depression and Anxiety in the Primary Care Setting. National Institute of Mental Health, Mental Health Medications. U.S. Food and Drug Administration, Depression Medicines. U.S. Food and Drug Administration, FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. Canadian Journal of Psychiatry (PMC), Canadian Network for Mood and Anxiety Treatments 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults. National Institute of Mental Health, Anxiety Disorders. National Institute of Mental Health, Depression. National Institute of Mental Health, Psychotherapies. MedlinePlus, Antidepressants.