I take Hydroxyzine. It’s an antihistamine that is also sometimes prescribed for anxiety, and it’s taken on a mostly as-needed basis. It’s pretty mild, but it does take the edge off and help me function better. It’s non-addictive, which is one thing I like about it. It does make you pretty drowsy for a few days while your body adjusts to it, but that usually goes away. As far as most effective, there isn’t really any one drug because drugs work differently for different people. Some people will have worse side effects than other people or one person might see better results than another person on the same drug. You could get a genetic test to test how your genes and metabolism interact with the drugs, but that still doesn’t show everything about whether or not a drug will be the most effective (speaking from personal experience). Any way you do it, there is going to have to be some trial and error. Also, there are a few drugs for anxiety like benzodiazepines that have the potential to be addictive. I would highly recommend seeing a psychiatrist rather than just a regular doctor for medication prescription and management if you can. Most regular doctors have little training and expertise in this area. My psychiatrist is WAY better and more knowledgeable on the topic. I took an expensive newer antidepressant prescribed by my family doctor for depression and anxiety for 6 or 7 months without it ever working, but my psychiatrist helped me wean off of it, and the very first medication she prescribed me worked wonders!

Definitely second asking for a genetic test! Been trying to find anxiety meds for over 10 years and still cannot tolerate any prescribed. Most of the ones I was actually prescribed weren’t genetically compatible with me. If I had started with that, I may have been able to find something to help by now. If this is first time trying some out just be careful- let someone know you’re trying it to check on you just in case the reaction isnt what you expected. And take it when you have nothing to do (at home or in a safe place) to see how it effects you first. When I take hydroxyzine I’m horribly grumpy and can’t think straight or stay awake- turn into bratty 2 year old. So I only take at night when needed and other things aren’t helping therefore it’s only useful for my anxious racing thoughts to shut off enough for me to fall asleep. There was a fire in apartment next door in middle of night and I had already taken it and did not even care to leave. Or feel like safe enough to be seen/leave- social anxiety. Like a wiry was so bad but didn’t care to fight it because of the meds. So definitely doesn’t actually help me deal with life. Most anxiety meds make me feel like I don’t care about anything- which isn’t actually helpful. So yeah anxiety meds effect ppl differently. I haven’t found one that I can function off of yet but many ppl do. I’m not saying this to scare you but only because I wish someone would’ve told me or been there to make sure I was at least ok when I did start trying them when I was younger. For me if I’m trying something new I plan out not to have anything important going on or have to drive just in case until I can gauge how it’s affecting me. I’m pretty sure I’m a more rare case tho (mostly bad reactions to psych meds) so please keep that in mind.

Escitalopram has pretty minimal side effects but it’s up to the individual.

Follow up: my doctor is suggesting setraline.