Starting Anxiety Medication-What to Expect in the First Weeks, and What It Costs
If you and a doctor have decided to try medication for anxiety, knowing what the first few weeks are genuinely like removes a great deal of the fear that surrounds it. The medicines most often used, the SSRIs, are not sedatives and not addictive in the way people worry about, but they are also not instant as they take a few weeks to build their effect, and the first week or two can feel unsettled, with some nausea, disturbed sleep or, in some people, a temporary increase in anxiety before it starts to improve. That early phase is expected, it is usually mild and short-lived, and it is exactly why medication is started at a low dose, increased slowly, and paired with proper follow-up rather than handed over and forgotten. Medication also works best alongside talking therapy rather than instead of it, and the decision to take it, or not, is always yours. This article explains what to expect so the process feels understood rather than frightening. At The Online GP by The Wellness in Marylebone, a GMC-registered doctor starts you on treatment carefully, reviews it properly, and is available while you settle in. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
If you are in crisis or feel unsafe at any point, do not wait: call 999 or go to your nearest A&E, call NHS 111, or call the Samaritans free on 116 123 at any time.
Message us about starting treatment on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
First, the decision is yours, and it is not a failure
Choosing to try medication for anxiety is a valid, common decision, not a sign of weakness or of having run out of other options. For many people with moderate or persistent anxiety, medication meaningfully reduces the symptoms that therapy and self-help alone have not fully settled, and it can create the space in which therapy works better. It is one tool among several, and using it is a practical choice about what will help you, not a verdict on how you have coped.
Equally, it is genuinely a choice, made with a doctor who has assessed you rather than one applied automatically. A good conversation weighs how much your anxiety is affecting your life, what you have already tried, your preferences, and any physical factors that should be checked first, and only then settles on whether medication, therapy, or both is the right next step. Understanding that you are deciding with the facts, and can change course, is the foundation for starting well.
What the medication actually is
The medicines most commonly used for anxiety are SSRIs, selective serotonin reuptake inhibitors, and understanding what they are and are not removes much of the worry. They are not sedatives or tranquillisers, so they do not knock you out or dull you, and they are not addictive in the way people fear, though they are stopped gradually rather than abruptly when the time comes. They are not "happy pills" that change who you are; at their best, they turn the volume down on the anxiety so you feel more like yourself, not less.
The one thing they are not is instant. SSRIs work by gradually adjusting brain chemistry over weeks, so the meaningful benefit usually appears somewhere around four to six weeks, building rather than switching on. This delay is the single most important thing to understand before starting, because the commonest reason people abandon a medication that would have helped is stopping in the first fortnight when they feel unsettled and not yet better. Knowing the timeline in advance is what carries you through the early phase to the point where it works.
Ask what to expect from your medication on WhatsApp or email team@thewellnesslondon.com.
What the first weeks are really like
Treatment is started low and increased slowly for a reason. In the first week or two, before any benefit appears, some people notice mild side effects as the body adjusts: nausea, headache, changed sleep, or feeling a little more restless or anxious than usual. These are usually mild, tend to settle within a week or two, and are far more manageable when you know to expect them rather than being alarmed by them. Starting at a low dose is specifically designed to keep this early phase gentle.
Then, usually somewhere from around two weeks onward and more clearly by four to six weeks, the picture changes: the background anxiety begins to ease, sleep and appetite often improve, and the things that felt overwhelming become more manageable. The improvement is gradual rather than sudden, which is why looking back over a few weeks is more revealing than judging day to day. A doctor reviews you during this period to check how you are settling, adjust the dose if needed, and reassure you through the early phase, which is precisely when support matters most.
The safety points that matter
Most people start an SSRI without any difficulty, but a few points deserve clear, honest attention. Occasionally, in the first weeks, anxiety or agitation can briefly increase before it improves, and it is important to know this can happen so it does not come as a shock and so you can tell your doctor. In particular, there is a recognised note that in young people, especially those under twenty-five, there can rarely be an increase in agitation or in thoughts of self-harm early in treatment, which is exactly why close follow-up in the first weeks is part of proper care, not an optional extra. If at any point you feel worse in this way, or have thoughts of harming yourself, treat it as urgent and seek help immediately using the numbers at the top and bottom of this page.
Two further points: do not stop an SSRI abruptly, because stopping suddenly can cause unpleasant discontinuation effects, so any change is planned and tapered with your doctor; and tell your doctor about all your other medications and any alcohol use, because interactions matter. None of this is a reason for alarm, and the great majority of people start treatment smoothly, but a doctor who sets these expectations honestly and stays available in the first weeks is what makes starting safe. This is why medication belongs with proper follow-up rather than a single prescription.
Follow-up is the treatment, not an extra
Starting a medication and never reviewing it is one of the commonest failures in this area, and it is avoidable. Proper treatment means a review a couple of weeks in to see how you are settling and catch any early problems, a further review around the four-to-six-week mark to judge whether it is working and adjust the dose, and ongoing check-ins after that. This is where the dose is fine-tuned, where a medication that is not suiting you is changed rather than endured, and where the plan is kept matched to how you are actually doing.
Medication also tends to work best alongside talking therapy, which addresses the patterns behind the anxiety while the medication eases the symptoms, and a doctor-led route can arrange both. The aim throughout is not to keep you on medication indefinitely by default but to help you get well and, in time, to review whether and how to come off it. That combination of careful starting, real follow-up and therapy alongside is what turns a prescription into treatment that works.
What does starting anxiety medication cost in London
Privately, this is priced as the assessment and the follow-up that make treatment safe, rather than the medication itself, which is inexpensive. A private psychiatrist runs £300 to £500 or more for an initial assessment with follow-ups charged on top, which is thorough but costly, particularly for what is often a straightforward start managed well by an experienced GP.
At The Online GP by The Wellness the assessment and treatment are doctor-led and joined up. A doctor consultation is from £220 in person and £150 by video, which includes assessing you, ruling out physical contributors where relevant, and starting treatment appropriately, with follow-up reviews to see you through the first weeks, matching to an accredited therapist from £150 a session where therapy is part of the plan, and referral to a psychiatrist where a presentation warrants it. Many patients have a workplace wellness allowance, an employee assistance programme or private medical insurance that covers this, and we provide an itemised invoice for reimbursement. The figure that matters is the cost of starting treatment safely and being supported through it, rather than a prescription with no follow-up.
Why The Online GP by The Wellness is the best place in London for starting anxiety medication
Because starting well depends on honest expectations and real follow-up, and that is how this care works. A GMC-registered doctor assesses you, explains clearly what the medication is and is not and what the first weeks will feel like, starts you low and slow, and stays available while you settle, with reviews at the points that matter rather than a single prescription. The safety points are set out honestly, therapy is arranged alongside where it helps, and the plan is kept matched to how you are doing, with the aim of getting you well rather than simply medicated. The clinic is in Marylebone three minutes from Baker Street, the doctors are multilingual, and the approach is supportive and unhurried. For something that works best when it is started carefully and followed up properly, that is what matters.
Book an assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
How long do anxiety tablets take to work
Usually around four to six weeks for the meaningful benefit, building gradually rather than switching on. The first week or two can feel unsettled before it improves, which is expected and why treatment is reviewed during this period rather than judged too early.
Are SSRIs addictive
No, not in the way people fear. They are not sedatives or tranquillisers and do not cause the cravings of an addictive drug, but they are stopped gradually rather than abruptly, because stopping suddenly can cause unpleasant discontinuation effects. Any change is planned with your doctor.
Will anxiety medication change my personality
No. At their best, SSRIs turn down the anxiety so you feel more like yourself, not less, rather than dulling or altering who you are. If a medication makes you feel flat or not yourself, tell your doctor, because that can be adjusted or the medication changed.
Can I feel worse before I feel better
Sometimes, briefly. Some people notice more restlessness or anxiety in the first weeks before it improves, which is why treatment is started low and reviewed early. If you feel significantly worse, or have thoughts of harming yourself, seek help urgently using the crisis numbers on this page and tell your doctor.
Will I be on medication forever
Usually not. The aim is to help you get well and then, in time, to review whether and how to come off it, tapering gradually with your doctor. Many people take it for a defined period, often alongside therapy, rather than indefinitely.
How much does it cost to start anxiety medication privately in London
A private psychiatrist runs £300 to £500 or more. At The Online GP by The Wellness a doctor consultation is from £220 in person and £150 by video, including assessment, starting treatment and the follow-up that sees you through the first weeks, with therapy from £150 a session where it is part of the plan.
The Online GP by The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic, three minutes from Baker Street. All doctors are GMC-registered. This article is general information and not a substitute for personal medical advice, and medication should be started and changed only under a doctor's guidance. If you are in crisis or feel unsafe, call 999, go to A&E, call NHS 111, or call the Samaritans on 116 123 at any time.
Enquire on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. NICE guidance on generalised anxiety disorder and panic disorder, and on depression in adults, including SSRI treatment, review schedules and withdrawal. MHRA and NICE advice on SSRIs, early monitoring and the increased vigilance recommended in people under 25. Royal College of Psychiatrists patient information on antidepressants. Published 2026 London private psychiatry and GP pricing.
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