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Some prescription medications used to treat chronic conditions or manage pain also carry the potential for dependence and misuse. These medications fall into a different category than most and are classified as controlled substances.

Managing a Prescription for a Controlled Substance

The distinction between controlled and non-controlled substances is an important one, as controlled substances are more heavily regulated than other prescription medications. There are limits on refills, and additional steps may also be required to get your prescription. Specific restrictions depend on factors such as your insurance plan’s benefits and the laws in your state. For example, many insurance providers limit the quantity of a controlled medication that they will cover over a given period of time.

Read on to learn how to manage your prescription for a controlled substance.

Controlled substances are regulated under federal law. The category includes both prescription medications and illegal drugs.

These substances are further categorized into five schedules, based on factors including their medical use, safety, and potential for misuse or dependency, with Schedule I substances being the most regulated.

Schedule I substances have no currently accepted medical use and are defined by the U.S. Drug Enforcement Administration (DEA) as having a high potential for misuse. Substances categorized into this schedule include heroin, ecstasy, and marijuana.

Schedule II substances are defined by the DEA as having a high potential for misuse and severe psychological or physical dependence. Substances categorized into this schedule include both illegal drugs such as cocaine and methamphetamine as well as prescription medications such as meperidine (Demerol®), oxycodone (OxyContin®), fentanyl, Dexedrine®, Adderall®, and Ritalin®.

Schedule III substances are defined by the DEA as having a moderate to low potential for physical and psychological dependence. Substances categorized into this schedule include some codeine-containing products, like Tylenol® with codeine; ketamine; anabolic steroids; and testosterone.

Schedule IV substances are defined by the DEA as having a low potential for misuse and a low risk of dependence. Substances categorized into this schedule include alprazolam (Xanax®), diazepam (Valium®), lorazepam (Ativan®), zolpidem (Ambien®), and Tramadol (ConZip®, Ultram®).

Schedule V substances are defined by the DEA as having an even lower potential for misuse than Schedule IV substances. Substances categorized into this schedule contain limited quantities of certain narcotics, including Robitussin AC®, Lomotil®, Motofen®, Lyrica®, and Parepectolin®.

Under federal law, there is a 30-day limit on the supply of any controlled substance. Additional federal restrictions on filling or refilling controlled substances vary by schedule. Some states may have additional restrictions or requirements for filling a controlled substance prescription. Here’s a brief overview.

No refills are allowed for schedule II substances. A new prescription from your healthcare provider is required for every fill.

Some states require a hand-written prescription with a provider’s signature.

Some states have expiration dates for Schedule II prescriptions, but there isn’t a federal law.

You are allowed to refill a prescription for these medications with a provider’s authorization.

If your provider has authorized refills, you are typically allowed up to five refills in six months. After five refills, a new prescription is required.

A prescription for a Schedule III, IV, or V medication expires after six months. After six months, a new prescription is required regardless of how many refills are left.

Tips for safe use of a controlled medication

If you are prescribed a controlled substance, it is especially important to keep track of your medication supply and take your medication only as directed. Never adjust the frequency or dose of your medication without consulting your provider. Make sure that anyone who prescribes a medication for you is aware of any other medications you take.

Be aware that some providers ask patients to sign a written agreement to ensure safe use of controlled substances like pain medication. These agreements may require that you only fill your prescription at one pharmacy and don’t take controlled substances prescribed by another provider.

Filling a prescription for a controlled substance at Alto

Given the additional regulations of controlled substances, these medications are currently not eligible for auto refills or medication bundling at Alto. Your convenience and safety is our priority, and we hope to expand these services to include controlled substances in the future.

Delivery of these medications requires a signature from you or an authorized signer. To add an authorized signer to your Alto account, head to Account > Delivery Addresses > Edit Address > Delivery Instructions in the Alto app.

In states where a written prescription is required to fill a controlled medication, these prescriptions cannot be transferred to Alto from another pharmacy.

Our team can answer any questions you have about your prescriptions. We also offer free, same-day delivery and medication management tools like reminders and auto refills to make it as simple as possible to stay on track with your treatment.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Egg freezing, a fertility preservation treatment that allows you to store unfertilized eggs for potential use in the future, has grown increasingly popular throughout the past decade. Between 2010 and 2016, the number of U.S. women who pursued the treatment increased by 880%. The trend has continued, with the Centers for Disease Control and Prevention (CDC) reporting that 123,304 egg freezing cycles were successfully completed in 2020 alone.

What to Consider Before Freezing Your Eggs

While egg freezing is a worthwhile experience for many women and people assigned female at birth, it is a deeply personal decision. There are many factors to consider as you evaluate if it’s right for you, including your individual health, finances, and family building goals.

Informing yourself about the process is a critical first step. Here’s an overview of what egg freezing entails — physically, emotionally, and financially.

Egg freezing is an option for anyone interested in preserving their fertility for personal or medical reasons.

All people with ovaries are born with the total amount of eggs they’ll ever produce — about a million on average. Each person’s egg count decreases with time. While only one egg matures enough to be released from the ovaries during a typical menstrual cycle, thousands of follicles, or potential eggs, are lost each time your body prepares for ovulation. As a result, the quantity and quality of eggs start to steadily decline in the early 30s, with a more significant decline from the mid 30s on.

Though many women successfully conceive naturally after 35, there is a correlation between pregnancy rates and age. By allowing you to try to conceive at a later age with eggs collected earlier, successful egg freezing offers a more flexible timeline for family building, and, in many cases, peace of mind. While many pursue the process with clarity about their reproductive goals — and the intention of a future pregnancy — others are undecided about having children and simply wish to leave their options open.

Egg freezing is also an option for people whose fertility may be impacted by medical factors like the following:

Cancer treatment: Some cancer treatments, including chemotherapy, radiation therapy, hormone therapy, and surgery of a reproductive organ, can impact a person’s fertility. For this reason, many women of reproductive age choose to freeze their eggs before starting treatment.

Other health conditions: Many individual health factors can influence fertility. Treatment for conditions like endometriosis or benign tumors may include removal of the ovaries. Women with a family history of ovarian cancer may pursue elective removal of the ovaries.

Gender-affirming surgery or treatment: The biological process of transitioning can permanently or temporarily impact a person’s ability to conceive. Many transgender men and transmasculine people freeze their eggs prior to hormone therapy or surgery. 

An egg freezing cycle is physically demanding, with self-administered injections and a minimally invasive procedure to retrieve your eggs.

In most cases the process begins with a transvaginal ultrasound, which allows your doctor to estimate your egg quantity. The following blood tests can provide additional information about the number of eggs in your ovaries:

The anti-mullerian hormone (AMH) test measures your body’s levels of a hormone associated with ovarian reserve. It is a good indicator of egg quantity, but not egg quality.

The follicle stimulating hormone (FSH) blood test measures your body’s levels of another hormone associated with your ovarian reserve.

Test results can also help your doctor predict your body’s response to fertility medications and tailor your treatment plan accordingly.

After the initial ultrasound and blood work, your doctor will prescribe stimulation medications to spur the growth of follicles, fluid-filled sacs in your ovaries that potentially contain an egg. These are some of the medications you may take during this stage:

These medications are typically taken as nightly injections.

Most ovulation suppression medications are typically introduced around days 5-10. These medications prevent premature ovulation — the body’s natural release of eggs from the ovaries — so that your doctor can retrieve as many eggs as possible.

These are some of the medications you may take at this stage:

Cetrotide/Fyramedel™ (ganirelix acetate)

While leuprolide is considered a suppression medication, it is typically started at least a week prior to stimulation medications.

Once your eggs have sufficiently developed, your doctor will schedule 1-3 trigger shots to give your eggs a final growth spurt and trigger release.

Medications used for trigger shots include:

If your body doesn’t respond to the stimulation medications or you have a decreased ovarian reserve, your doctor may add one of the following ancillary medications to your protocol to increase your chances of success.

Omnitrope® — a growth hormone whose main purpose is to help improve the quality of eggs

Microdose leuprolide injections — a lower dosage of leuprolide used to boost ovarian response to stimulation medications

The final step in a successful cycle is egg retrieval. In this minimally invasive procedure, your doctor will gently guide a thin needle through your vaginal wall and use suction to draw the eggs from the follicles. Your eggs will then be stored in a facility for however long you choose to.

While the retrieval itself takes 15 to 45 minutes, you should plan to be at the clinic for several hours. Many people find it helpful to have a friend or family member accompany them to the clinic for support before and after.

Each cycle typically takes 10-14 days from the beginning of medication use to egg retrieval. You will have regular doctor’s appointments for additional ultrasounds and blood work while taking stimulation and ovulation suppression medications. Your doctor may adjust medication dosages based on your hormone levels.

If and when you decide to use your frozen eggs, they will be thawed, fertilized with sperm, and implanted into your uterus through the process of in vitro fertilization (IVF).

For some women, it is a viable option to freeze embryos, or fertilized eggs. There are several reasons a person might opt to freeze embryos:

Some studies have found that frozen embryos have a higher thaw survival rate than frozen eggs. 

Embryos can undergo genetic testing, so you can learn of any chromosomal abnormalities before freezing them. 

You will also know that you are freezing an egg healthy enough for successful fertilization.

However, this option requires you to decide whose sperm to use early on in the process.

Your doctor may recommend that you stop taking hormonal birth control before your egg freezing cycle, as it may affect fertility assessment results as well as your body’s response to fertility medications. Non-hormonal forms of birth control, like a copper IUD, should not interfere with the egg freezing process.  

What else should I consider before freezing my eggs?

The egg freezing process affects both the mind and body, with physical and emotional side effects. While each person responds differently to the treatment, certain symptoms are common, including:

Injection site reaction (soreness, redness, or mild bruising)

Changes in mood such as heightened sensitivity, irritability, euphoria, or depression due to elevated estrogen levels

Alto’s fertility-trained pharmacists can help you navigate egg freezing side effects, with availability on nights and weekends.

Different injectable fertility medications require different administration methods. Most injections are administered subcutaneously around the abdomen. Intramuscular injections are typically administered in the upper, outer part of the buttocks, which can be more difficult to reach when self-injecting.

If your protocol includes intramuscular injections, consider asking for assistance from your partner, a friend, or a family member. If you need to self-administer, try standing in front of a mirror for a better view of the injection site. You can also ask a nurse or another clinic staff member to circle the injection site on your body so that you can find it more easily.

Like any medical procedure, egg freezing has the potential for some complications. Egg retrieval may cause bleeding and infection, though this is unlikely to occur in most cases.

One rare, but serious, complication of the process is ovarian hyperstimulation syndrome (OHSS), an abnormal reaction to stimulation and trigger medications. It is characterized by pain and swelling in the ovaries and sometimes the abdomen. OHSS is treatable, but there are times when a doctor will recommend ending treatment and starting a new egg freezing cycle in the future.

While many women successfully conceive with frozen eggs, it’s important to remember that fertility preservation treatment does not guarantee a successful pregnancy. There are many steps between egg retrieval and pregnancy, including successful thawing, fertilization, implantation, and continued embryo development.

It may also take several cycles to retrieve your target number of eggs, which your doctor will advise you on. An average of 10-15 eggs are needed to achieve a successful pregnancy. Depending on your age and reproductive health, your doctor may recommend freezing more eggs to increase your chances of successfully conceiving.

Not everyone who freezes their eggs will use them. Some women go on to conceive naturally while others decide not to pursue parenthood. As part of your planning, consider what you would do with unused eggs or embryos. Your options include donating them to a person or couple experiencing infertility or to researchers, or having them appropriately discarded by a clinic or storage facility.

Donating eggs will require additional blood work and testing prior to your cycle. Ask your clinic for additional information if you are interested in this option.

Before deciding to pursue egg freezing, it’s important to know how you will pay for the treatment. Egg freezing costs are ongoing, including not only the fertility medications, testing, blood work, and procedures, but also storage fees and in vitro fertilization. (Many clinics store eggs for up to a year as part of the cost of an egg freezing cycle. If your clinic offers this service, you will need to select another storage vendor after a year.)

The total cost of egg freezing depends on various individual factors. Your reproductive health and your age can influence how many egg freezing cycles your doctor recommends. Egg storage duration depends on your personal family building timeline.

It may not be possible to predict the exact total cost of egg freezing, but identifying your reproductive goals and learning more about your reproductive health can help you arrive at a solid estimate. An initial consultation with a fertility clinic is often a helpful first step, providing additional insight into personal health factors.

Some health insurance plans offer partial or full coverage of egg freezing-related costs, including medications and IVF. Note that most insurance plans have separate medical and pharmacy benefits. In most cases, professional services provided by your doctor or clinic will fall under medical benefits, and fertility medications will fall under pharmacy benefits.

A growing number of employers offer egg freezing coverage as part of employee benefits, separate from health insurance. If your employer doesn’t currently cover egg freezing, don’t be afraid to ask. RESOLVE: The National Infertility Association has resources to help you start the conversation.

Some fertility clinics offer financing and payment plans to help you manage or lower egg freezing costs. As you explore your options for clinics, we suggest asking these questions:

Based on my specific treatment plan, what is the typical all-inclusive cost?

What is included in the treatment cost and what is not?

Is a year of egg storage included in an egg freezing package?

Can you provide a detailed list of procedures and costs?

What is the typical cost of fertility medications for my treatment plan?

Additionally, some fertility medication manufacturers offer patient assistance programs to alleviate the cost of these expenses. If Alto is your fertility pharmacy, you are likely taking medications manufactured by EMD Serono or Ferring Pharmaceuticals. Both manufacturers have programs that lower the cost of fertility treatment.

Learn how to apply for EMD Serono’s financial assistance programs.

Learn how to apply for Ferring Pharmaceuticals’ financial assistance programs.

Alto is committed to helping you save as much as possible on your fertility medications. Free same-day delivery makes it easy to manage last-minute changes to your treatment plan, preventing fertility medication waste. We also search for savings options and connect you with programs that require you to apply, like the patient assistance programs above.

A pharmacy partner for your fertility journey

Egg freezing can be a challenging journey, but Alto is with you every step of the way. To ensure that your treatment plan is followed correctly, we offer free same-day delivery of your medications and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

Interested in learning more about how Alto can support your treatment? Request a price quote online or reach out through secure in-app messaging or by phone at 1-800-874-5881.

Each October, American Pharmacist Month is an opportunity to not only celebrate the dedication of pharmacists and pharmacy technicians, but also to shine a light on all that they do.

National Pharmacists Month Spotlight: Gabrielle Kaplan

The average American visits a pharmacy 35 times a year, and the availability of pharmacists has the potential to address many gaps within healthcare, like access to the underutilized HIV prevention medication PrEP.

Many people who could benefit from the medication are unable to get a prescription from their primary care provider, whether it’s because they live too far from the doctor’s office or aren’t comfortable speaking about their sexual health. There's growing recognition that expanding the role of pharmacists in HIV prevention can help increase PrEP usage.

At Alto, we’re committed to maximizing the possibilities of pharmacy care. Not only do we divide our pharmacy roles into fulfillment and patient advocacy — we have numerous specializations under the umbrella of patient advocacy that allow our pharmacists to be part of the solution to precisely these healthcare challenges.

As part of our coverage of American Pharmacist Month, we spoke with Gabrielle Kaplan, a specialty patient care pharmacist who makes HIV prevention medication and treatment for complex chronic conditions more manageable for patients.

I’m a patient care pharmacist in our specialty department. We oversee medications that aren’t as common and which often have more side effects — or more serious side effects — including HIV medications, PrEP for HIV prevention, and injectable medications used to treat chronic conditions like psoriasis, rheumatoid arthritis, and high cholesterol.

The side effects associated with these medications can keep people from continuing with them. Since there’s a team of us whose sole focus is serving the patients who take these medications, they don’t just stop treatment. And they don’t have to worry about reaching out to us — we proactively check in. If anything is bothering them, we’ll take the initiative to call their provider and discuss their concerns.

What motivated you to focus on specialty pharmacy, specifically HIV treatment and prevention?

I was very interested in learning more about HIV treatment back in pharmacy school since a family member had passed away from it. The medications available today have drastically transformed what a diagnosis even means. I was excited by the possibilities, and it was always on my radar as a potential interest for the future. Working at Alto is the first time that I’ve been able to completely immerse myself in this specialization.

It’s a rapidly evolving area of both medicine and pharmacy, and there continues to be so much opportunity for pharmacists to take on a bigger role. In my state of Colorado, pharmacists can prescribe the HIV prevention medications PrEP and PEP. At Alto, we’re always discussing these updates and trying to expand the scope of what we offer patients and how we support their treatment.

What challenges have you encountered as a pharmacist?

By far the biggest pain point I experienced in retail pharmacy was staffing and having the number of pharmacists needed to execute all the day’s tasks while still providing great patient care.

Everyone working in a pharmacy is doing their very best, but there’s only so much we can do in an allotted time. It’s a disservice to patients and to those who work in the field — trying to balance the demands with your own mental well-being becomes nearly impossible.How do Alto’s pharmacy specializations make a difference for you and your patients?

Having a specific focus on patient care allows us to actually deliver quality patient care. At retail pharmacies where one pharmacist is doing it all, you’re trying to fill a prescription while on the phone and with someone yelling at you from across the room.

With fulfillment and patient advocacy separated at Alto, we are each able to focus on what’s in front of us at any given moment. For me, that means I can give patients my full and undivided attention and spend as much time with them as possible.

We have such a great team and plenty of support, so there’s no need to worry about other people’s tasks. We can each do the jobs that we’ve been specifically trained and are uniquely equipped to do.

What else is unique about Alto’s model?

The digital model makes it so that geography is less of an obstacle to care, and that each patient in our service areas has access to all of our resources. This is particularly relevant to my division of specialty pharmacy.

Many traditional retail pharmacies don’t have a specialty pharmacy in every physical location. Sometimes the specialty pharmacy is one centralized location from which everything is mailed. That means you won’t necessarily have a pharmacist in your local store who’s familiar with your medications and able to counsel you.

The medication used to treat or prevent HIV is complex, and it can be difficult to stay on track with treatment. The fact that any Alto customer taking these medications can talk to a pharmacist with deep expertise in that area of pharmacy makes a world of difference.

As a pharmacist, what does “care” mean to you?

It means always putting patients first — thinking about the care you would want a family member or friend to receive and delivering just that.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison.

A child’s diabetes care needs don’t stop during the school day, and starting a new school year or returning to the classroom after a diagnosis can be overwhelming for students and parents alike. Advanced planning and coordination with school staff can ease the transition and ensure that your child has everything they need to stay safe and healthy while at school. Below, we highlight the most important steps to take.

Managing Your Child’s Diabetes at School

To ensure effective management of your child’s diabetes during the school day, school staff should be informed of your child’s treatment plan as well as what to do in the event of a hypoglycemia or hyperglycemia emergency. There are two important plans to finalize and share with the school.

A diabetes medical management plan (DMMP) is the foundation of your child’s care regimen at school. It translates your endocrinologist’s recommendations into actionable items for your child’s school nurse, teacher, and other school staff members who are responsible for students.

A DMMP should cover every aspect of your child’s diabetes management, including the following. The American Diabetes Association has a detailed DMMP template that you can use as a starting point.

Insulin therapy needs, including the delivery device and timing of dosages and whether to contact you to adjust a dose

Important considerations for physical activities

Diabetes care needs — and the amount of support a child needs with them — evolve with time. Include information about your child’s self-care skills in your plan, clarifying specifically what support will be required from staff. Each school year, revisit your child’s DMMP with your endocrinologist and make updates if needed.

As you finalize your child’s treatment plan and your DMMP, consult with your endocrinologist about your insulin delivery device options. Many children find it convenient to use an insulin pump while at school, given the ease of use and automated timing of injections.

Insulin pens, which combine insulin and a syringe into a single device, also allow for faster and easier administration than syringes. (Some types of insulin pens are covered under pharmacy benefits — Alto may be able to help your child get started with these devices.)

You may also want to explore a continuous glucose monitoring (CGM) device for your child’s blood glucose monitoring needs. In contrast to traditional blood glucose meters (BGMs), which provide a single blood glucose reading by pricking a finger, CGMs automatically collect glucose readings regularly throughout the day. They can identify patterns that aren’t as easily captured by a traditional BGM and eliminate the need to step away for blood sugar readings. (Some CGMs give you the option of adding “followers,” so that you can alert your child’s provider and the school nurse to a potential emergency.)

504 Plan or Individualized Education Program (IEP)

After your DMMP has been finalized, the next step is to draft a 504 plan or individualized education program (IEP). This plan takes all of the information about your child’s care needs from the DMMP and documents the school’s specific responsibilities.

If the school nurse will typically oversee your child’s care, a 504 plan should address who will step in if the nurse is unavailable. Account for after-school activities and events and field trips as well.

Share any relevant information with your child. For example, make sure they know who to go to for help with blood sugar testing or if they experience symptoms of low blood sugar.

This plan should be revisited each year and shared with anyone who will be responsible for your child during the school day or at school events. View the ADA’s template for a 504 plan.

Many staff members are integral to a child’s diabetes management during the school day: the school nurse, your child’s teacher, and administration, as well as the sponsors of extracurricular activities and nutrition service staff. Their knowledge of diabetes and level of comfort overseeing care may vary. In addition to distributing the DMMP and 504, consider asking your healthcare professional to lead a special training for key staff members.

Have one-on-one conversations as needed to get any information about school policies that impact your child’s diabetes. Here are some topics to cover with specific staff members.

Make sure that you, your child, and your child’s teacher are on the same page about each other’s needs. Ask about classroom rules and guidelines, such as what a student needs to do in order to leave the room — is it necessary to ask permission each time? Let the teacher know more about your child’s specific signs of hypoglycemia, as these vary by individual.

Many children with diabetes find it helpful to bring lunch to school, for carbohydrate counting purposes. If your child will eat meals in the cafeteria, request information about the menu and dietary guidelines from a member of the nutrition services team.

Participating in physical activities is both beneficial to your child’s diabetes management and important for their social life. Share any relevant information with the physical education instructor or another staff member to ensure that your child can safely participate.

Make sure your child’s school has all diabetes essentials on hand, including the following:

Blood glucose meter and extra batteries (include these as a backup even if your child uses a CGM)

Insulin and syringes or pens (include these as a backup even if your child uses a pump)

In addition, be sure that the school has the supplies needed to treat hypoglycemia in an emergency. Ideally, there will be one emergency kit in the nurse’s office and another in the classroom. Label it with your child’s name and include the following:

During your conversations with school staff, discuss a system for keeping track of supplies and notifying you when low.

Lastly, your child should wear a medical ID necklace or bracelet to school every day. This will ensure that they receive prompt and correct treatment in the event of an emergency.

A partner in your child’s diabetes care

Navigating your child’s diabetes diagnosis is easier with a reliable pharmacy partner. At Alto, we’re committed to making it as simple as possible to manage diabetes, with free same-day delivery and medication management tools like reminders and auto refills in our app. And our dedicated diabetes support team is here to ensure that you have all the information you need to follow the treatment plan your child’s doctor recommends.

Reach out any time by phone at 1-800-874-5881 or secure in-app messaging.

Recognizing and Treating Anxiety, The Most Common Mental Health Disorder

Some degree of anxiety is natural. In fact, it can even be beneficial in certain contexts, like pre-interview butterflies. Other times, however, anxiety can become so debilitating that it interferes with daily life. Frequent and intense feelings of nervousness may be indicative of an underlying mental health disorder.

Anxiety disorders are the most common type of mental health disorder in the U.S., affecting more than 40 million adults, or about 19%. It is also estimated that 7% of children and adolescents between the ages of 3-17 struggle with symptoms of anxiety.

Over the past few years, as Covid-19 brings much upheaval and change, the number of Americans suffering from anxiety disorders and depression continues to increase. As a result, the U.S. Preventive Services Task Force is now recommending that all adults under the age of 65 be screened for anxiety. 

For many of those with an anxiety disorder, treatment — in the form of medication, psychotherapy, or both — is necessary to manage symptoms and maintain an active and fulfilling life. Below, we explain more about some of the most common treatment options.

Many factors can contribute to anxiety, including genetics, environment, behaviors, and situations. Common causes and risk factors include:

Having another mental health disorder such as depression

Genetics - having a relative with an anxiety disorder is considered a risk factor

Certain personality traits such as shyness

Individual experiences of anxiety can vary, so your anxiety symptoms may be different from those of a friend or family member with the condition. Anxiety can cause physical sensations like butterflies in your stomach or a racing heart. It can also bring an overall feeling of fear or unwanted thoughts.

Digestive issues, stomach pain, or nausea

Thoughts or flashbacks of a traumatic experience

Anxiety disorders are highly treatable with medication and therapy. (A combination of both is necessary for many people with an anxiety disorder.) While it can be difficult to share your feelings with a healthcare provider, it’s an important first step in managing symptoms.

These are some indications that you may benefit from treatment for anxiety:

Anxiety, fear, or worry has interfered with work and relationships

You find it difficult to control your anxiety, fear, or worry

You are concerned about your use of alcohol or other substances

There are many options for medication to treat anxiety. Some are used on a short-term basis or as needed while others are taken daily in the long term. Your provider will make recommendations based on your specific symptoms.

Though it can be frustrating, finding the right medication for your anxiety symptoms can take some trial and error.

There are several types of medications commonly used to treat anxiety disorders.

Benzodiazepines are sedatives that induce a feeling of calm. They amplify the effects of certain chemicals that act as a messenger between brain cells.

Benzodiazepines commonly prescribed for anxiety include:

These medications are typically used for short-term treatment of acute symptoms and may be prescribed on an as-needed basis. They often cause side effects like drowsiness and difficulty with balance and memory.

While benzodiazepines are effective, they have the potential for dependence and misuse. As a controlled substance under the U.S. Drug Enforcement Administration’s guidelines, there are tight regulations for prescribing and dispensing benzodiazepines.

Benzodiazepines are not safe to abruptly discontinue. If you have been taking a benzodiazepine for longer than two weeks, speak with your doctor about slowly tapering off to avoid withdrawal symptoms and lower the risk of seizure.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) increase a person’s levels of serotonin, a chemical in the brain that affects mood. Increased serotonin levels can alleviate symptoms of anxiety. These medications are considered a frontline treatment option for anxiety disorders and are also used to treat depression.

SSRIs commonly prescribed for anxiety include:

While SSRIs are very effective for many people with anxiety, it typically takes several weeks to experience their benefits. Even if you don't feel like the medication is working, continue to take it as prescribed so that you can achieve a therapeutic level. If you still have concerns several weeks into treatment, speak with your doctor.

Always consult your doctor before stopping an SSRI. It is not recommended to frequently start and stop SSRIs, and they should not be taken on an as-needed basis.

SSRIs have been linked to the following side effects, though they are mild in the majority of cases. Speak with your doctor about any concerns.

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) increase levels of serotonin — just like SSRIs — but they also increase norepinephrine, which boosts energy and focus. These medications may increase your energy levels in addition to alleviating symptoms of anxiety.

SNRIs commonly prescribed for anxiety include:

Venlafaxine extended-release (Effexor® XR)

There are additional medications used to treat anxiety that do not belong to the medication classes above.

The antihistamine hydroxyzine (Atarax®, Vistaril®) blocks histamine and boosts the effects of serotonin. As the only antihistamine that offers this effect, it is the only antihistamine used to treat anxiety. This is typically an option for those who experience side effects with SSRIs or SNRIs, or who have concerns about the addictive potential of benzodiazepines.

Buspirone (Buspar®) is another alternative to SSRIs and SNRIs. While it isn’t entirely understood how buspirone works, the medication likely activates certain areas of the brain to make serotonin more active.

Each person metabolizes medications differently. Open communication with your provider can help identify the medication that works best for you. Your doctor should know:

Any other medications you are prescribed and their dosages

Blog

Managing a Prescription for a Controlled Substance

What to Consider Before Freezing Your Eggs

National Pharmacists Month Spotlight: Gabrielle Kaplan

Managing Your Child’s Diabetes at School

Recognizing and Treating Anxiety, The Most Common Mental Health Disorder

What to Know About PrEP Follow-Up Appointments and Testing

Medication Bundling: One Delivery for All Your Prescriptions

Meet the Innovation Team Building Alto's Next Big Bets

Get to know Jake Moffatt, Engineering Manager on the Alto Assistant Team

Meet the Newest Members of Our Advisory Board

A Full Pharmacy At Your Doorstep: Introducing Essentials from Alto

The Evolution of HIV Medication

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