Best Antidepressants: Choosing the One That’s Right For You

Struggling with both anxiety and depression can feel overwhelming. Remember that you’re not alone, and there are effective treatments that can help. 

One of the most common and successful approaches is antidepressant medication. Most antidepressants are also “anxiolytic”–meaning they help to treat symptoms of anxiety as well. But with so many options available, how do you find the best antidepressant for anxiety and depression? 

The answer depends on your unique symptoms, health history, and treatment goals. 

In this article, we’ll explore the top medications that doctors commonly prescribe for co-occurring anxiety and depression, what sets them apart, and how to choose the right one for your needs.

What is the Best Antidepressant for Anxiety and Depression? 5 Top Antidepressants for Anxiety and Depression

If you’re struggling with anxiety and or depression, there are effective medications that can help. But which antidepressant is best for anxiety and/or depression? What is the highest-rated antidepressant for anxiety? 

Here we discuss the top five antidepressants for anxiety and depression, their common side effects, and what to expect once you start taking them.

1. Effexor XR (Venlafaxine ER)

Effexor XR is a serotonin-norepinephrine reuptake inhibitor (SNRI). It works by increasing the levels of serotonin and norepinephrine, which play vital roles in stabilizing mood and reducing anxious thoughts.

Effexor XR is often prescribed when SSRIs don’t provide enough relief, and it has shown notable benefits in individuals with both generalized anxiety disorder (GAD) and major depressive disorder (MDD). It also targets physical symptoms of anxiety, such as restlessness and muscle tension.

Common Side Effects: Patients frequently report nausea, headache, dry mouth, insomnia, and dizziness, especially during the early weeks. Increased blood pressure is possible at higher doses. Effexor XR also has a reputation for difficult withdrawal symptoms if doses are missed or stopped abruptly.

What to Expect: Symptom relief may begin within 2–4 weeks, though full benefits can take 6–8 weeks. Starting at a low dose and slowly increasing may reduce side effects. It’s important to stay hydrated and take the medication with food to minimize nausea.

2. Prozac (Fluoxetine)

Prozac is a selective serotonin reuptake inhibitor (SSRI) that’s FDA-approved for depression, panic disorder, and obsessive-compulsive disorder. It increases serotonin levels in the brain and helps improve emotional resilience.

Fluoxetine is considered a first-line treatment for depression with anxiety. It’s also useful for people who have struggled with motivation or fatigue, thanks to its mildly energizing effects.

Common Side Effects: Fluoxetine may cause initial anxiety, restlessness, insomnia, decreased appetite, and sexual side effects such as reduced libido or difficulty reaching orgasm. Some people report gastrointestinal issues like nausea or indigestion.

What to Expect: Prozac’s long half-life (four to six days) means it stays in your system longer than many antidepressants. This can be helpful in avoiding withdrawal, but it means it may take longer to adjust to. Side effects often subside within two weeks.

3. Lexapro (Escitalopram)

Lexapro is another top SSRI widely prescribed for both major depressive disorder and generalized anxiety disorder. It is known for its clean pharmacologic profile and low risk of drug interactions.

Lexapro has demonstrated strong efficacy in clinical trials for both depression and anxiety. It is often considered one of the best-tolerated SSRIs, even in individuals with high sensitivity to medication.

Common Side Effects: Typical side effects include fatigue, nausea, increased sweating, dizziness, dry mouth, and occasional sexual dysfunction. Some users also report weight gain with long-term use.

What to Expect: Lexapro often begins to improve symptoms within the first month, though full benefits may take 6–8 weeks. It’s typically started at a low dose to reduce side effects and gradually adjusted based on how you respond.

4. Zoloft (Sertraline)

Zoloft is an SSRI that affects serotonin levels to ease symptoms of depression and a variety of anxiety disorders. It is FDA-approved for conditions including social anxiety disorder, panic disorder, PTSD, and OCD.

Zoloft is particularly versatile, showing high effectiveness in individuals with anxiety-related rumination and social anxiety. It’s also one of the most studied SSRIs in diverse populations.

Common Side Effects: The most reported side effects include nausea, diarrhea, agitation, insomnia, and sexual dysfunction. In some people, it may initially heighten anxiety before it begins to reduce it.

What to Expect: Zoloft tends to show benefit within 2–4 weeks, but like most SSRIs, full effects may take a bit longer. Starting with a lower dose and titrating up helps with tolerability. It’s a solid option for people with broad-spectrum anxiety symptoms.

5. Wellbutrin (Bupropion)

Unlike SSRIs and SNRIs, Wellbutrin is a norepinephrine-dopamine reuptake inhibitor (NDRI). It works differently by increasing norepinephrine and dopamine rather than serotonin.

While not typically prescribed as a first-line treatment for anxiety alone, Wellbutrin is very effective for depressive symptoms, particularly when fatigue, low energy, or difficulty concentrating are prominent. It’s also a common add-on therapy to SSRIs.

Common Side Effects: Common side effects include dry mouth, insomnia, increased sweating, anxiety or jitteriness (especially early on), and headaches. It has a low risk of sexual side effects and is less likely to cause weight gain—in some cases, it may even promote weight loss.

What to Expect: Because of its stimulating properties, Wellbutrin is usually taken in the morning. It may not be ideal for individuals with severe anxiety, but it’s highly effective for those whose depression is characterized by low energy and motivation or who are concerned about sexual side effects.

How to Choose the Best Antidepressant and Anxiety Medication for Your Needs: 5 Tips

Finding the right antidepressant involves more than picking the most well-known medication. It’s about understanding your specific symptoms, how your body responds to different drugs, and the broader context of your mental and physical health. 

Here are five key tips to guide your decision-making process when choosing the best medication for anxiety and depression.

1. Talk Openly With Your Provider

Your healthcare provider plays a critical role in helping you navigate antidepressant options, but their guidance is only as good as the information you share. 

Be honest about your current symptoms, previous medication experiences, lifestyle, and any fears or preferences you have.  This includes letting your provider know if certain side effects (like weight gain, fatigue, or sexual dysfunction) are deal-breakers for you. 

The more they understand your goals and concerns, the more tailored and effective their recommendation will be.

2. Consider Your Main Symptoms and Diagnosis

Not all antidepressants are created equal, and different medications target different symptom clusters. 

If your dominant symptoms are anxiety-related, such as chronic worry, panic attacks, or social fear, SSRIs like Lexapro or Zoloft are often first-line options. 

On the other hand, if you struggle more with symptoms like low energy, poor concentration, or loss of pleasure, Wellbutrin might be a better fit due to its energizing effects. 

Co-occurring conditions like PTSD or OCD may also guide which medication is most appropriate.

3. Evaluate Side Effect Profiles Carefully

Each class of antidepressants comes with its own set of potential side effects. SSRIs and SNRIs may cause nausea, sleep issues, and sexual side effects, while NDRIs like Wellbutrin are more activating and less likely to impact libido or weight. 

Take stock of what matters most to you. For instance, if maintaining your weight or avoiding sedation is a priority, this will narrow the list of suitable options. 

Discussing these trade-offs with your provider is key to making an informed choice you can stick with.

4. Be Patient With the Process

Most antidepressants don’t provide immediate results. It can take 4 to 6 weeks—or sometimes longer—to feel their full effect. 

During that time, some side effects may appear early but fade with continued use. Avoid the temptation to stop or switch medications too quickly, unless side effects are severe or intolerable. 

Your provider may recommend dose adjustments or supportive strategies (like therapy or lifestyle changes) while waiting for the medication to reach its full potential.

5. Factor in Lifestyle and Other Health Conditions

Antidepressants don’t exist in a vacuum. Your other medical conditions, medications, and even your daily routine can influence how well a drug works for you. 

For example, if you have high blood pressure, Effexor XR may not be the best choice due to its potential to raise blood pressure at higher doses.  If you suffer from insomnia, a more sedating SSRI might be helpful. 

Let your provider know about all ongoing health issues, as well as your sleep patterns, energy levels, and work or family responsibilities that might interact with treatment outcomes.

Need an Anxiety and Depression Consultation?

At Brightside Health, we take a personalized, evidence-based approach to treating anxiety and depression. 

Our licensed providers specialize in matching each individual with the right medication and care plan based on their unique symptoms, preferences, and treatment goals. 

With online access to therapy, medication management, and ongoing support, Brightside makes it easier than ever to get help from anywhere.

The Best Antidepressants for Anxiety and Depression: Key Takeaways

There’s no definitive answer to what the best antidepressants for depression and anxiety are. However, medications like Effexor XR, Prozac, Lexapro, Zoloft, and Wellbutrin are among the most effective and widely prescribed. 

Choosing the right one requires consideration of your symptoms, side effect preferences, and collaboration with a trusted healthcare provider. 

With the right support, you can find a treatment that brings lasting relief.

FAQs

What is the highest-rated antidepressant for anxiety in 2025?

Lexapro continues to be highly rated in 2025 for its balance of effectiveness and tolerability. It’s often a first-choice medication for individuals with both anxiety and depression due to its consistent results and fewer side effects.

What is the most common SSRI for anxiety?

What’s the best SSRI for anxiety? There’s no “best” SSRI, but Zoloft (sertraline) is currently one of the most commonly prescribed SSRIs for anxiety. Its broad FDA approval makes it a go-to option for panic disorder, social anxiety, and generalized anxiety.

What is the best antidepressant for anxiety and weight loss?

Wellbutrin (bupropion) is often favored for those looking to avoid weight gain. It’s stimulating and may promote weight loss in some users, though it’s not typically the first choice for pure anxiety.

What is the strongest antidepressant for anxiety?

Effexor XR (venlafaxine) is considered one of the stronger antidepressants for anxiety, particularly for treatment-resistant cases or individuals with severe symptoms.

What is the strongest antidepressant for severe depression?

Tricyclic antidepressants (like amitriptyline) or SNRIs like venlafaxine are often prescribed for more severe cases. These medications can be powerful but may come with more side effects, requiring closer monitoring.

What is the best SSRI for anxiety and depression?

Lexapro is frequently considered the best SSRI for both anxiety and depression due to its strong efficacy and minimal side effect profile. It is well tolerated and suitable for long-term use.

Which antidepressant works best for anxiety without causing weight gain?

Wellbutrin (bupropion) stands out as a weight-neutral option and is even associated with weight loss in some patients. While it’s not ideal for everyone, it’s a strong contender for those concerned about weight changes.