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Reviewed by Dr. Arjun Mehta, PharmD — Head Pharmacist. Updated May 2025.
US adults with anxiety
With insomnia
Main drug classes
Anxiety and insomnia are closely linked: each makes the other worse, and both respond to similar treatments. Mild-to-moderate cases respond well to cognitive behavioural therapy (CBT) and lifestyle measures. Medication can be a useful adjunct or alternative for moderate-to-severe symptoms.
The main drug groups are SSRIs (long-term anxiety control), benzodiazepines (short-term anxiety or insomnia, dependence risk), Z-drugs (short-term insomnia), and beta-blockers (situational performance anxiety). Buspirone is a non-sedating non-addictive option for generalised anxiety.
Sertraline, escitalopram. First-line for generalised anxiety, panic and OCD. Takes 4–6 weeks for full effect.
Propranolol. Useful for performance anxiety — controls physical symptoms (tremor, racing heart) without sedation.
SSRIs are not addictive but can cause discontinuation symptoms if stopped abruptly. Always taper under medical supervision.
Most are not. Short-term use is fine; long-term use of Z-drugs and benzodiazepines is associated with dependence and rebound insomnia.
If anxiety or insomnia affects daily functioning, lasts more than a few weeks, or is accompanied by suicidal thoughts — seek help promptly.
/our-pharmacists/arjun-mehta/ — Reviewed May 2025
This guide is reviewed every 12 months or sooner when clinical guidance changes. If you have a specific medical question, call our pharmacist team — we answer the phone, not a bot.
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