5 over-the-counter treatments for stress and anxiety

Everyone experiences some amount of stress and anxiety, whether it’s caused by big life changes, busy seasons, or more serious issues—like illness or the sudden loss of a loved one. But sometimes stress becomes chronic, affecting your physical health and your mental health. Sometimes, anxiety isn’t triggered by anything external but comes from within, interfering with your ability to function in your daily life.

Suppose your stress or anxiety level seems unusually elevated. In that case, you’re not alone: about 19% of the U.S. population lives with an anxiety disorder, and according to our own 2024 stress statistics, about 75% of Americans report frequent symptoms of stress like fatigue and headaches.

Although stress and anxiety don’t always require treatment with medication, both over-the-counter and prescription medications can be used to alleviate your symptoms. In addition to the often-prescribed antidepressants like Zoloft, some vitamins and supplements are associated with reducing levels of stress and anxiety and may be a safe choice for people who want to enhance the effects of their existing treatment.

5 over-the-counter treatments for anxiety and stress

There are dozens of over-the-counter (OTC) medications, vitamins, and supplements marketed as stress- or anxiety-relieving. Still, it’s important to know that many of these products are not backed by enough quality research or evidence. You can stock up on valerian root, ashwagandha, and chamomile, but the science for many of these natural remedies is unconvincing—and herbal supplements are not safe for everyone to take, carrying the risk of interaction with other medications or existing medical conditions. Finally, while some vitamins and supplements are a safe, convenient, and affordable way to find relief from stress and anxiety, they shouldn’t be used in place of appropriate medical care.

“OTC options aren’t a substitute for professional advice, and self-diagnosis can be risky,” says Faisal Tai, MD, psychiatrist and founder of PsychPlus.com. “Persistent or severe anxiety symptoms require evaluation by a healthcare professional who can recommend appropriate treatments, which may include prescription medications or therapy.”

That said, here are the five best OTC treatment options for stress and anxiety based on expert advice and scientific research. Always consult a healthcare provider before starting a new treatment, even if it has natural ingredients.

1. Magnesium

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Magnesium is an electrolyte your body needs to perform many functions, including regulating muscle and nerve function, maintaining blood pressure, and developing protein and bone. Many people also recommend it for overall relaxation and improved sleep, which can have drastic positive effects on your mood. Several studies looking at magnesium’s effectiveness in improving sleep quality have been generally positive.

For example, a 2023 review of studies found that people getting enough magnesium reported better sleep than people who didn’t (though random clinical trials weren’t able to confirm a direct link between magnesium supplementation and sleep quality). Some people also recommend taking magnesium supplements for muscle relaxation because it helps regulate muscle contractions and can aid in muscle recovery after a workout.

In general, magnesium is relatively safe, and adults may be able to supplement with as much as 400 to 600 milligrams per day; however, too much magnesium can cause gastrointestinal distress. Certain medications can interact with magnesium, while others can affect magnesium levels.

• Taking magnesium with a bisphosphonate drug, such as Fosamax, can decrease the medication’s absorption. These medications will need to be separated by several hours.
• Certain antibiotics (quinolones such as levofloxacin, or tetracyclines such as doxycycline) can interact with magnesium and will need to be separated by several hours. 
• Many diuretics, also known as water pills, can cause low magnesium levels. Some diuretics, known as potassium-sparing diuretics (such as spironolactone), can cause increased magnesium levels.
• Proton pump inhibitors (PPIs), such as Nexium (esomeprazole), when taken for a long time, can cause low magnesium levels.

Check with your healthcare provider or pharmacist for more information about magnesium interactions.

2. Melatonin

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Perhaps the most well-known dietary aid for better sleep, melatonin supplements are a synthetic version of the “sleepy time hormone” your body produces naturally as part of your daily circadian rhythm. Because melatonin can cause drowsiness, you can’t use it for daytime relaxation, but even nighttime use can cause daytime drowsiness. Because it can help improve sleep patterns, it can indirectly impact your stress levels, says Dr. Tai.

Often, a small amount of melatonin is enough to help people fall asleep more quickly and stick to a consistent sleep schedule; start with just one or two milligrams and add more from there if needed. Just be careful not to rely on melatonin or any sleep aid on an ongoing basis, says Emma Kimball, LCSW, founder of Emma Kimball Counseling, who explains that melatonin can be a good way to maintain your sleep in times of high situational stress, but you don’t want to be in a situation where you can’t sleep without it. Melatonin is not recommended for chronic insomnia (insomnia lasting for one month or longer).

3. L-theanine

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L-theanine, an amino acid found in tea leaves like green tea and black tea, is another supplement that some people believe promotes relaxation, Dr. Tai says. Researchers are still working to understand how L-theanine might have this effect, but a few small studies have shown some promise.

A 2019 study found that L-theanine supplementation improved sleep quality and executive functioning scores in participants versus placebo, while a 2022 study found the amino acid to be potentially helpful in decreasing symptoms of stress, anxiety, and depression. L-theanine from tea is also considered to be generally safe for most people, although supplements are stronger, and you should check with a healthcare provider before using. Also, excessive amounts could cause side effects such as GI upset or difficulty sleeping.

4. Vitamin B-complex

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Vitamin B-complex supplements, particularly B6 and B12, may help you manage symptoms of stress and anxiety, says Dr. Tai, since they play a role in neurotransmitter synthesis and can support a healthy nervous system. In 2019, researchers conducting a review of studies on the relationship between vitamin B supplementation and stress found evidence supporting the benefits of supplementation on overall stress and mood levels.

In other research, vitamin B deficiencies have been associated with an increase in neurological and psychological symptoms like depression and dementia. Low doses of vitamin B6 and/or B12 are also considered generally safe to take, though, as always, check with your healthcare professional before using, especially if you have certain conditions like heart or kidney problems. 

5. Omega-3s

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Omega-3 fatty acids have the potential to promote better brain health, though researchers are still working on figuring out if they can actually benefit people with mood disorders and anxiety. Some studies suggest that increasing your intake of omega-3 fatty acids with a fish oil supplement may reduce anxiety symptoms and could also have an antidepressant effect. However, the results of these studies are often conflicting, and there needs to be more consensus about how much omega-3 supplementation can actually provide benefits.

While fish oil supplements are largely safe, they can also cause GI distress, such as nausea and heartburn, along with a fishy aftertaste and bad breath.

Traditional treatment methods

The gold standard for treating mental health conditions like anxiety is usually a combination of two things:

1. Professional psychotherapy (particularly cognitive behavioral therapy)
2. Prescription medication

Typically, the first-line anti-anxiety medications include selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Less commonly, other drugs like tricyclic antidepressants may be used, but these drugs often have more side effects. Benzodiazepines, such as Xanax (alprazolam), carry a risk of dependency and are not recommended for routine use.

There are many different approaches to the treatment of anxiety, so it’s important to talk with a healthcare provider and share any concerns or preferences you have about possible treatments. “Medication is certainly not the most important way we manage symptoms of anxiety,” says Charles Rismyhr, MD, primary care physician at Houston Methodist Willowbrook Hospital, who emphasizes coupling therapeutic support with a prescription medication, if needed.

What else can you do to relieve stress and anxiety?

The good news is that most mental health experts will tell you that lifestyle changes can make a huge difference in your symptoms, especially when used in conjunction with therapy. In that way, there are many things you can do to further improve your symptoms beyond taking a vitamin, supplement, or prescription drug.

1. Eat a balanced diet. According to Dr. Tai, a diet rich in nutrient-dense foods is essential to maintaining mental health. Omega-3 fatty acids found in fatty fish like salmon, or flaxseeds, can positively impact brain health and mood regulation, he explains. At the same time, complex carbohydrates like whole grains and lean protein sources can help promote and stabilize a positive mood.
2. Exercise regularly. Physical activity, especially anything that raises your heart rate for 20 minutes or more, may even be more effective than supplements, medicine, or counseling for stress and anxiety, says Dr. Rismyhr. The mental health effects of exercise can be both short-term, felt within minutes of completing a physical activity, or long-term, decreasing anxiety levels after an extended period of regular exercise.
3. Hydrate. Dr. Tai says even mild dehydration can affect mood and cognitive function, so make sure you’re getting enough fluids each day. Aim to drink half your body weight in ounces.
4. Limit caffeine and alcohol. Although people often use beverages to unwind and relieve stress or feelings of anxiety, Dr. Tai says excessive consumption of caffeine and/or alcohol can actually make your symptoms worse. You don’t have to avoid them completely, but try to stick to the recommended guidelines for both: less than 400 milligrams of caffeine per day and one (for women) or two (for men) alcoholic beverages per day. And be mindful of serving sizes, too—one standard drink is equal to 12 ounces of beer, 8 ounces of malt liquor, or 5 ounces of wine.
5. Prioritize sleep. Sleep is critical for general health and especially helpful for anxiety relief, says Dr. Rismyhr. In fact, not getting enough sleep is a risk factor for developing anxiety symptoms; a 2023 review of studies found that sleep loss increased heart rate and feelings of worry in participants, plus decreased positive mood and reduced the intensity of emotions.
6. Practice relaxation techniques. Meditation and mindfulness practices have been shown to have a beneficial effect on anxiety symptoms as well as symptoms of stress. These techniques can be simple, requiring very little effort on the part of the person feeling anxious; for example, the “3-3-3 Rule for Anxiety” is an easy strategy that can be done virtually anywhere. To try the 3-3-3 rule to ground yourself during anxious moments, look around you and identify or name three things you can see and three things you can hear, then touch, move, or feel three physical, tactile things.

The bottom line: Supplements work best with therapy and Rx

In general, the best approach to treating stress and anxiety is to seek medical advice; a combination of therapy with a mental health professional, lifestyle changes, and prescription medication can improve your symptoms and help you develop coping strategies for stress and anxiety in the future.

If you’re considering adding a natural remedy to your treatment, you must discuss any dietary supplements with your healthcare provider. If they give you the green light to take OTC supplements like magnesium, melatonin, or vitamin B, you might find even more relief. But it’s important to use herbal remedies safely and know the potential role they can play in your treatment.

“As a therapist, I strongly encourage lifestyle adjustments and talk therapy to help manage anxiety,” says Kimball. “Supplements can be used to do just that—supplement your other mental health work.”