What is the first-line medication for acute anxiety?

The first-line treatment for acute anxiety typically includes medications that provide rapid relief of anxiety symptoms, and this is where short-acting benzodiazepines or buspirone come into play. Benzodiazepines, such as lorazepam or alprazolam, act quickly by enhancing the effect of GABA, a neurotransmitter that inhibits nervous system activity. This leads to a calming effect, making them effective for managing episodes of acute anxiety.

Buspirone, while not as quick-acting as benzodiazepines, is also used for anxiety. It works differently, primarily as a serotonin receptor agonist, which may contribute to its anxiolytic effects. However, it may take several weeks to notice its full benefits, so it is not typically the first choice for acute situations.

In contrast, other options like beta blockers can help manage some physiological symptoms of anxiety, such as tachycardia or tremors, but do not directly address the psychological aspects or general anxiety. Antidepressants, including SSRIs, are frequently used to treat chronic anxiety disorders but require more time to become effective and are not suitable for immediate symptom relief. Therefore, when immediate intervention is required for acute anxiety, benzodiazepines and sometimes buspirone are