Anxiety has become a nationwide health crisis in the United States, affecting more than 40 million people. The economic toll of anxiety disorders surpasses $42 billion annually, which represents nearly one-third of the country's overall mental health spending.
Each year, doctors write tens of millions of prescriptions for anti-anxiety drugs such as Xanax and Ativan, making them among the most frequently prescribed medications. These belong to a class of drugs called benzodiazepines.
Scientists haven't fully determined the precise way benzodiazepines operate, but the prevailing theory is that they boost levels of the calming neurotransmitter gamma-aminobutyric acid (GABA) or heighten the sensitivity of GABA receptors. Other medications in this category, often referred to as “benzos,” include brand names like Centrax, Dalmane, Klonopin, Librium, Paxipam, Restoril, Serax, Tranxene, and Valium.
These drugs can halt anxiety or a panic episode almost instantly. Relief usually appears within 30 to 60 minutes and typically lasts between 11 and 20 hours. Although these medications may feel like a lifesaver for anyone dealing with anxiety, there are compelling reasons to steer clear of them whenever possible. As an old Chinese proverb says, “The bigger the front, the bigger the back.” And these drugs come with an enormous downside.
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The Dark Side of Anti-Anxiety Pills
Benzodiazepines like Xanax and Ativan carry a lengthy roster of adverse effects. According to RXList.com, they frequently cause drowsiness, dizziness, weakness, confusion, or unsteadiness. Additional reported side effects include depression, disorientation, headache, mental fog, irritability, aggression, memory impairment, and sleep disturbances. Long-term use raises the likelihood of developing dementia. A study discovered that the more benzodiazepines you accumulate over time, the higher your chances of Alzheimer's disease.
Anti-anxiety drugs are intended only for short-term use — a few weeks or months at most — because they are extremely habit-forming. After four to six months, they typically lose effectiveness, which is common with any addictive substance. Users build tolerance, requiring larger doses to achieve the same effect.
While addiction often takes months to develop, for some individuals it can happen much sooner — in as little as a few weeks. Once you become dependent, quitting these medications is extremely difficult. In fact, they rank among the “top 10” hardest addictive substances to overcome, alongside heroin and cocaine.
If you choose to stop taking Xanax, expect to face fairly intense withdrawal symptoms, including anxiety, insomnia, restlessness, muscle tension, and irritability. You're correct if you notice these resemble the very reasons you started taking it in the first place. But the situation can get far worse. Some users experience depression, nausea, blurred vision, sweating, hallucinations, delusions, and seizures.
Certain groups of people should never use these drugs. Benzodiazepines are not safe if you are pregnant, over 65, or susceptible to addiction. You must never take them if you consume alcohol or use other drugs, whether prescription or illicit. Benzodiazepines send more than 100,000 people to emergency rooms annually. Over 80 percent of those visits result from interactions with other substances or alcohol. In rare instances, these interactions can be fatal.
Finally, these drugs don't work for everybody. A small fraction of users have paradoxical reactions, becoming more anxious, impulsive, and aggressive.
Drug-Free Options for Anxiety
If you're thinking that these medications — sometimes called “mother's little helper” — don't seem all that helpful, you're absolutely right. Fortunately, a wide range of natural alternatives to anti-anxiety drugs exists.
Below are some natural substitutes for Xanax, Ativan, and other prescription anxiety medications. Most have been proven effective without side effects in scientific studies, while all boast a substantial and often lengthy history of use in traditional and alternative medicine.
Picamilon
By fusing GABA with niacin, picamilon offers a method to deliver GABA into the brain. This “new and improved” version of GABA delivers prescription-strength relief for anxiety, depression, high blood pressure, and migraine headaches. It possesses nootropic properties and is favored by college students who use it to sharpen focus and memory. It is believed to be particularly beneficial for social anxiety.
Kava (Piper methysticum)
Kava deserves a top spot on any natural anxiety relief list. This traditional beverage has been safely consumed as an integral part of South Pacific culture for more than 3,000 years. When tested against the antidepressants Buspirone and Opipramol, kava proved equally effective for anxiety and generalized anxiety disorder (GAD) as the prescription drugs. Kava works, in part, by increasing GABA.
You might encounter warnings that kava can cause liver damage, but this is an unfounded fear. Decades ago, kava was linked to a small number of liver-related deaths, yet 85 studies failed to definitively establish a connection. The NIH concluded that the risk of liver injury from taking a kava supplement is less than one in one million, making it several orders of magnitude safer than Xanax. If you're still worried, you can read more about the liver toxicity controversy here.
Inositol
Inositol, once called vitamin B8, is present in high concentrations in the brain. All major neurotransmitters depend on inositol to relay messages between brain cells. Inositol serves as an effective natural anti-anxiety remedy.
One study found it performed as well as fluvoxamine, a popular selective serotonin re-uptake inhibitor (SSRI), for treating panic disorder. Fluvoxamine is used for a range of other mental conditions, including obsessive-compulsive disorder (OCD), social anxiety disorder, eating disorders, schizophrenia, post-traumatic stress disorder (PTSD), and major depressive disorder (MDD). Participants who took fluvoxamine reported nausea and fatigue, whereas those who took inositol experienced no side effects.
Inositol is also an excellent option for women dealing with mood swings, depression, and anxiety linked to premenstrual syndrome (PMS) and the more severe premenstrual dysphoric disorder (PMDD). Women who use inositol often see substantial improvement in PMS and PMDD symptoms.
Inositol is found in most foods but in very small quantities. The average diet provides about 1 gram of inositol. For therapeutic purposes, you may need up to 18 grams daily. Since most inositol pills and capsules contain 500 mg, that would mean taking a large number of pills. Instead, consider using inositol powder, which can be mixed with water.
Gotu Kola (Centella asiatica)
Unfortunately, the name Gotu Kola evokes thoughts of caffeinated cola drinks or kola nuts, but nothing could be more misleading. Gotu kola is actually a relaxing herb that plays an important role in some Asian cuisines. Yogis use it as a meditation aid because it is thought to restore balance between the left and right hemispheres of the brain. Studies show gotu kola can boost calmness, contentment, and alertness by 100 percent and reduce symptoms of anxiety and depression by 50 percent.
Arctic Root (Rhodiola rosea)
As its name implies, Arctic Root (also known as Rhodiola rosea) grows primarily in cold regions of the world. It was traditionally used in Chinese medicine to enhance physical stamina and reduce fatigue caused by stress. One way Arctic root works is by increasing the activity of the feel-good brain chemicals serotonin, dopamine, and norepinephrine. Arctic root eases symptoms of anxiety and seasonal affective disorder. It can also help people with fibromyalgia and chronic fatigue syndrome manage the stress and anxiety that often accompany these conditions.
Holy Basil (Ocimum sanctum)
Holy Basil is an Indian Ayurvedic herb also called tulsi, which means “the incomparable one.” Holy basil is believed to grant its users a long and healthy life. Holy basil relieves anxiety by lowering levels of stress hormones, particularly cortisol. It offers significant relief to those with generalized anxiety disorder and related stress and depression.
Research supports the traditional view that this revered herb possesses a wide range of healing properties. It is antimicrobial and anti-inflammatory. It protects the liver, heart, and nervous system. It has anti-diabetic and anti-cancer effects. It can also help with other brain-related disorders, including depression, memory loss, insomnia, and migraine headaches. Given all these benefits, holy basil is regarded as one of Ayurvedic medicine's most important healing herbs.
Ashwagandha (Withania somnifera)
Ashwagandha is another key herb in the Ayurvedic healing tradition. Its name literally means “smell of horse,” which is fitting because it smells like a horse and is said to give those who take it the strength and stamina of one. Ashwagandha reduces anxiety and depression without causing drowsiness. It works, in part, by increasing levels of the mood-boosting neurotransmitter serotonin while decreasing levels of the stress hormone cortisol. One study found that taking ashwagandha lowers cortisol by an impressive 27 percent. It is very helpful for those with the anxiety disorder agoraphobia.
The effectiveness of ashwagandha for anxiety is based more on the reported success of traditional use than on scientific evidence. According to naturopathic doctor Dr. Peter Bongiorno, author of How Come They’re Happy and I’m Not, “Most of the understanding we have about ashwagandha is based on its substantial anecdotal history and animal studies. But more clinical studies are being done.”
Taurine
Anti-anxiety drugs are believed to work by increasing the neurotransmitter GABA, and you can buy GABA supplements. However, they generally don't work because GABA is too large a molecule to enter the brain. A convenient way to bypass this problem is by taking GABA's precursor, taurine. Taurine is an amino acid found in high concentrations in the brain, where it acts very much like GABA. It has a calming effect if you suffer from anxiety, stress, insomnia, or an overstimulated mind.
Magnesium
Magnesium is an essential mineral that is often lacking in the modern diet due to magnesium-depleted soil and water. According to Dr. Carolyn Dean, author of The Magnesium Miracle, magnesium deficiency can be a major contributor to anxiety and panic attacks. She explains that when you are under stress, your body produces adrenaline, which triggers a cascade of physical effects, all of which consume magnesium.
After decades of studying magnesium, she has found the link between anxiety and magnesium to be so strong that she flatly states, “To put an end to anxiety, magnesium must be replaced.” Note that there are many forms of magnesium, and some are more bioavailable than others. Magnesium oxide, for example, is a popular, inexpensive form, but studies show that its fractional absorption (bioavailability) is only 4 percent. Dr. Dean recommends magnesium citrate as a good all-purpose magnesium supplement. You might also want to look into magnesium oil, which is applied topically, especially if you are susceptible to oral magnesium's laxative effect.
Switch To Green Tea
People around the world have a love affair with caffeine. Over 80 percent of Americans drink coffee every day, and millions more get their caffeine from energy drinks, soda, and tea.
But one of the best tips to reduce anxiety is to go caffeine-free. The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association's compendium of mental health conditions, recognizes four caffeine-induced disorders. The link between caffeine and anxiety is so strong that one study concluded that, “Assessment of caffeine intake should form part of routine psychiatric assessment and should be carried out before prescribing hypnotics” and that, “Decaffeinated beverages should be provided on psychiatric wards.”
If you aren't ready to go completely caffeine-free, consider switching to green tea. Its modest amount of caffeine is offset by the compounds l-theanine and EGCG (epigallocatechin-3-gallate). These relaxing compounds have the unique ability to alter your brainwave patterns, inducing a mental state similar to that achieved during meditation.
Even More Alternatives
Just as no single prescription medication works for everyone all the time, no one natural remedy is effective for everybody either. These are far from the only natural alternatives to prescription anti-anxiety drugs. If you try these and they don't help, don't get discouraged. There are many other options to explore.
Other supplements worth considering include B complex vitamins, chamomile, valerian, bacopa, ginkgo, ginseng, and oregano oil. The appropriate use of calming essential oils, especially lavender oil, can soothe away stress and anxiety.
Finally, not all natural alternatives to Xanax, Ativan, and anti-anxiety drugs are physical substances you ingest or apply — some are activities you engage in. Physical exercise, breathing exercises, meditation, and mind-body healing techniques like biofeedback, hypnosis, or Emotional Freedom Technique (EFT) should also be considered. These methods can help you address the root cause of your anxiety, ultimately freeing you from the need to take any kind of anti-anxiety pill.
