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Treatment - Generalised anxiety disorder

Generalised anxiety disorder is something you may have for a long time - but there are different treatments available.

Your GP will discuss all the treatment options with you. They will tell you about any possible risks or side effects.

You can decide on the most suitable treatment with your GP.

Initial treatment

Your GP may suggest guided self-help.

This usually involves working from a book or online programme. A health professional such as a psychologist or a mental health nurse will support you.

Ask your GP about local group courses for anxiety. At these courses you and a few other people with similar conditions meet with a therapist every week. You learn ways to manage your anxiety.

You may need talk therapy or medicine if initial supports do not help.

Find mental health supports

Psychological therapy

Your GP may recommend therapy. For example, cognitive behavioural therapy (CBT).

This involves talking to a trained therapist such as a counsellor, psychotherapist or psychologist.

Your GP can refer you to psychological therapy but you do not usually need a referral. If you want you can choose a therapist yourself.

Make sure the therapist is accredited by a professional body such as:

Talk therapy

Primary Care Psychology

A GP or another health professional can refer you to Primary Care Psychology. You can also refer yourself directly.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is one of the most effective treatments for generalised anxiety disorder. The benefits may last longer than the benefits from medicine.

CBT helps you manage problems by thinking in a more balanced way. It can free you from unhelpful patterns of behaviour.

It can also help you do things you would usually avoid.

CBT

Medicine for generalised anxiety disorder

If psychological treatments and talk therapies do not help, medicine might be the next option.

There is a range of medicines your GP can prescribe to treat general anxiety disorder.

Your GP can discuss options with you in detail, such as:

  • the different types of medicines
  • the length of treatment
  • the side effects and possible interactions with other medicines

You should see your GP regularly while taking medicine for generalised anxiety disorder.

Tell your GP if you think you may be experiencing side effects from your medicine. They may be able to adjust your dose or prescribe another medicine.

The main medicines for treating generalised anxiety are:

Selective serotonin reuptake inhibitors (SSRIs)

How it works and side effects

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant for treating anxiety and depression. They increase the level of a chemical called serotonin in your brain.

Medicines used for anxiety include:

  • sertraline (Depreger, Lustral, Seretral, Serimel and Serlan)
  • escitalopram (Esciprex, Escitalpro, Etalopro and Lexapro)
  • citalopram (Ciprager, Cipramil, Citrol and Ciprotan)
  • fluoxetine (Prozac, Fluzac and Prozamel)

SSRIs are taken on a long-term basis. You'll start with a low dose and increase as your body adjusts to the medicine.

They can take several weeks to start working.

Side effects of SSRIs

Common side effects of SSRIs include:

  • feeling agitated
  • feeling or being sick
  • indigestion
  • diarrhoea or constipation
  • loss of appetite and weight loss
  • dizziness
  • blurred vision
  • dry mouth
  • excessive sweating
  • headaches
  • problems sleeping or drowsiness
  • low sex drive
  • difficulty achieving orgasm during sex or masturbation
  • in men, difficulty getting or maintaining an erection

These side effects should improve after 2 weeks, but some side effects can persist.

If your medicine is not helping after about 2 months of treatment, talk to your GP.

When it's OK for you to stop taking your medicine, your GP will reduce your dose slowly. This reduces the risk of withdrawal effects.

Do not stop taking your medicine unless your GP advises you to.

Find out more about antidepressants

Serotonin and noradrenaline reuptake inhibitors (SNRIs)

How it works and side effects

Serotonin and noradrenaline reuptake inhibitors (SNRIs) are a type of antidepressant. They increase the amount of serotonin and noradrenaline in your brain. SNRIs can also increase your blood pressure.

Examples of SNRIs include:

Side effects of SNRIs

Common side effects of SNRIs include:

  • feeling sick
  • headaches
  • drowsiness
  • dizziness
  • dry mouth
  • constipation
  • insomnia
  • sweating

Some of the side effects are more common in the first 1 or 2 weeks of treatment. These usually settle as your body adjusts to the medicine.

Find out more about antidepressants

Pregabalin

How it works and side effects

If SSRIs and SNRIs are not suitable for you, pregabalin is an option. This is a medicine known as an anticonvulsant. It is used to treat conditions such as epilepsy. It can also help treat anxiety.

Side effects of pregabalin can include:

  • drowsiness
  • dizziness
  • increased appetite and weight gain
  • blurred vision
  • headaches
  • dry mouth
  • vertigo

Pregabalin is less likely to cause nausea or a low sex drive than SSRIs or SNRIs.

Learn more about pregabalin

Benzodiazepines

How it works and side effects

Benzodiazepines are a type of sedative, sometimes used as a short-term treatment. They are particularly effective during a severe period of anxiety. They will help to ease the symptoms within 30 to 90 minutes of being taken.

If you're prescribed a benzodiazepine, it will usually be diazepam.

Benzodiazepines are very effective in treating the symptoms of anxiety. But they can become addictive if you use them for longer than 4 weeks. Benzodiazepines also start to lose their effectiveness after this time.

They are usually not prescribed for any longer than 2 to 4 weeks at a time.

Side effects of benzodiazepines can include:

  • drowsiness
  • difficulty concentrating
  • headaches
  • vertigo
  • tremor (an uncontrollable shake or tremble in part of the body)
  • low sex drive

Referral to a specialist

If your anxiety does not go away after treatment, talk to your GP about a referral to a community mental health team (CMHT).

A CMHT usually has the following:

Members of the mental health team will ask about your difficulties.

They'll ask you about:

  • your previous treatment and how well it worked for you
  • things that may be affecting your condition, such as other health conditions
  • how much support you get from family and friends.

Your mental health team will then develop an individual care plan with you. This will focus on your goals and how to support you.

This plan may include a treatment you have not tried before.

You may need psychological therapy and medicine. A combination of 2 different medicines is also an option.


Content supplied by the NHS and adapted for Ireland by the HSE

Page last reviewed: 3 September 2025
Next review due: 3 September 2028