Anxiety medications list rankings have shifted dramatically in recent years, with Xanax no longer holding the top position many might expect. Anxiety disorders affect more than 40 million adults in the United States, making them the most common mental health condition nationwide. This widespread prevalence has led to significant changes in how these conditions are treated pharmacologically.
Surprisingly, gabapentin has emerged as the most prescribed anti-anxiety medication in 2024, accounting for nearly 22% of all anxiety prescriptions, followed by bupropion hydrochloride at 13.61%. For those researching the best medications for anxiety or considering options to buy Xanax online, it’s worth noting that prescribing patterns have changed substantially over time. Between 1996 and 2013, benzodiazepine prescriptions increased by 67% to 135 million prescriptions annually, but recent data suggests a shift away from these medications. In fact, approximately 30.6 million adults report using benzodiazepines, with 5.3 million misusing them, which has influenced prescribing practices.
In this article, we’ll examine whether Xanax maintains its formerly dominant position in 2025, explore the current landscape of anxiety treatments, and discuss the factors driving these significant changes in prescription patterns.
Is Xanax Still the Top Prescribed Anxiety Drug in 2025?
Despite its historical popularity, Xanax (alprazolam) has fallen to fourth place among anxiety medications, behind gabapentin (22% of prescriptions), bupropion hydrochloride (13.61%), and trazadone hydrochloride. This represents a significant decline from its peak in 2013 when 28.9 million Xanax prescriptions were written, compared to just 15.38 million by 2021.
In 2023, alprazolam ranked 37th overall among prescribed medications with approximately 15.9 million prescriptions. Additionally, while 20% of adults diagnosed with anxiety disorders received medication treatment in 2025, selective serotonin reuptake inhibitors (SSRIs) now dominate the anxiety medications list, accounting for 60% of global prescriptions.
The shift away from Xanax stems primarily from mounting concerns about benzodiazepines’ safety profile. Healthcare providers increasingly recognize that benzodiazepines carry serious risks including dependence, cognitive impairment, and potential for overdose. Furthermore, all patients who take benzodiazepines long-term develop physiologic dependence.
Medical professionals now generally limit Xanax prescriptions to short-term use—typically 2 to 4 weeks—often as a bridge while patients start SSRIs. When searching for the best medications for anxiety, patients should be aware that physicians now prefer medications with better safety profiles over benzodiazepines, especially for long-term management of anxiety disorders.
Types of Medications Used for Anxiety Today
The modern anxiety medications list encompasses several distinct drug classes, each with unique mechanisms for managing anxiety symptoms.
Selective serotonin reuptake inhibitors (SSRIs) currently serve as first-line treatments for most anxiety disorders. Medications such as escitalopram (Lexapro) and paroxetine (Paxil) increase serotonin levels by blocking its reabsorption in the brain. Though effective, these medications typically require 2-6 weeks before showing results.
Similarly, serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor XR) and duloxetine (Cymbalta) work by increasing both serotonin and norepinephrine levels. Studies indicate that higher doses of SSRIs, but not SNRIs, correlate with greater symptom improvement.
Beyond these options, benzodiazepines such as diazepam (Valium), lorazepam (Ativan), and alprazolam (Xanax) provide rapid relief by enhancing GABA effects. However, concerns about dependence have limited their recommended use to 1-2 weeks.
Alternative medications gaining traction include buspirone, a non-benzodiazepine anxiolytic; hydroxyzine, an antihistamine that relieves anxiety symptoms within 30 minutes; pregabalin (Lyrica), which modulates calcium channels; and beta-blockers like propranolol for physical anxiety symptoms.
Novel treatments under investigation show promise for addressing anxiety with fewer side effects, including compounds targeting brain circuits related to anxiety.
Shifting Preferences: What’s Replacing Xanax?
Several factors are driving healthcare providers to choose alternatives over Xanax on the anxiety medications list. Primary among these is safety concerns, with physicians increasingly cognizant of benzodiazepines’ high risk for dependency and abuse.
SSRIs have emerged as the predominant replacement, accounting for 60% of anxiety medication prescriptions globally. These medications typically require 4-6 weeks to reach full effectiveness, yet offer better long-term safety profiles.
Gabapentin has unexpectedly become the most frequently prescribed anxiety medication, despite being FDA-approved primarily for seizures and nerve pain. Its off-label use for anxiety has grown significantly due to its lower abuse potential compared to benzodiazepines.
Non-benzodiazepine options gaining traction include:
- Buspirone, which works specifically on serotonin receptors without sedative effects
- Beta-blockers like propranolol for physical symptoms of anxiety
- Pregabalin (Lyrica), which shows promise for generalized anxiety disorder
Consequently, those seeking to buy Xanax online should understand that healthcare standards have shifted substantially. Currently, the best medications for anxiety are considered those offering sustained relief without dependency risks. Healthcare providers now typically reserve benzodiazepines for acute anxiety situations, preferring alternatives with improved safety profiles for ongoing anxiety management.
Conclusion
The landscape of anxiety treatment has clearly evolved substantially since Xanax’s peak popularity. Concerns about dependency, cognitive impairment, and overdose risks have consequently pushed this once-dominant medication to fourth place among anxiety prescriptions. Healthcare providers now primarily view benzodiazepines as short-term solutions rather than ongoing treatment options.
SSRIs have undoubtedly become the cornerstone of anxiety management, offering better long-term safety profiles despite their delayed onset of action. Meanwhile, gabapentin’s rise to the top position represents a significant shift toward medications with lower abuse potential. This trend reflects a broader reconsideration of how we balance immediate symptom relief against long-term patient welfare.
Patients seeking anxiety treatment should therefore understand that medical consensus has moved away from quick-fix solutions toward sustainable management strategies. The ideal approach now typically involves medications with better safety profiles, possibly combined with therapy and lifestyle modifications. Though Xanax remains available and appropriate for specific situations, its role has diminished considerably.
The future of anxiety treatment appears focused on developing medications that target specific anxiety mechanisms without the drawbacks of benzodiazepines. Until then, the current diverse range of options—from SSRIs and SNRIs to buspirone and beta-blockers—provides multiple pathways for effective anxiety management. The goal remains finding treatments that offer relief without creating additional problems, making the decline of Xanax prescriptions a positive development for patient care overall.