Non-Controlled Medications for As-Needed Anxiety Management

First-Line Treatment Options

The American Academy of Family Physicians recommends an initial dosage of 5 mg twice daily, with a maximum dosage of 20 mg three times daily for buspirone, particularly useful for patients with mild to moderate anxiety symptoms 1
Buspirone may take 2-4 weeks to become fully effective, which is important to communicate to patients, according to the American family physician 1

Beta blockers, such as propranolol, may help with physical symptoms of anxiety, including tremor, tachycardia, and sweating, but are not recommended as primary treatment for social anxiety disorder, based on evidence from Neuropsychopharmacology 3
The American College of Neuropsychopharmacology suggests that beta blockers are best for situational anxiety with prominent somatic symptoms 3
Gabapentin can be considered when first-line treatments are ineffective or not tolerated, particularly for patients with comorbid pain conditions, according to Praxis Medical Insights 2

The Praxis Medical Insights guideline recommends avoiding abrupt discontinuation of any anxiety medication, even non-controlled ones, to prevent rebound symptoms 2
Neuropsychopharmacology advises caution when using beta blockers in patients with asthma, diabetes, or certain cardiac conditions 3