What anxiety medication is safe with Suboxone? Discover the best combinations for effective treatment.14 min read

If you or someone you know is struggling with both opioid addiction and anxiety, finding the right medication can be crucial for effective treatment. However, not all anxiety medications are safe to use in combination with Suboxone, a commonly prescribed medication for opioid addiction. In this article, we will explore the key points to consider when combining anxiety medications with Suboxone to ensure safe and successful management of both conditions.

  • Understanding Suboxone: Learn about Suboxone, its role in opioid addiction treatment, and how it works in the body.
  • Common Anxiety Medications: Explore different types of anxiety medications that are commonly prescribed and their potential benefits.
  • Possible Interactions: Understand the risks associated with combining anxiety medications and Suboxone, and the importance of careful monitoring.
  • Anxiety Medications Safe with Suboxone: Discover anxiety medications that are generally considered safe to use in combination with Suboxone.
  • Anxiety Medications to Avoid: Learn about anxiety medications that should be avoided while using Suboxone due to potential adverse effects.
  • Consulting Healthcare Professionals: Understand the significance of seeking medical guidance and individualized treatment plans.

Understanding Suboxone

Suboxone is a combination medication containing buprenorphine and naloxone, primarily used to treat opioid addiction. Buprenorphine helps reduce withdrawal symptoms and cravings, while naloxone prevents misuse of the medication. It works by binding to the same receptors in the brain as opioids, but with a milder effect, helping individuals gradually taper off opioid dependence. However, combining Suboxone with certain anxiety medications can lead to adverse reactions and should be carefully managed.

Common Anxiety Medications

There are several types of anxiety medications prescribed to alleviate symptoms such as excessive worry, fear, or panic attacks. SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) are among the most commonly prescribed anxiety medications. Additionally, buspirone and hydroxyzine are sometimes used for anxiety management. Each type of medication has unique mechanisms of action and potential benefits, but not all may be safe to use with Suboxone.


  • Examples: SSRIs include medications like sertraline, fluoxetine, and paroxetine, while SNRIs include venlafaxine and duloxetine.
  • How They Help: SSRIs and SNRIs increase the levels of serotonin and norepinephrine in the brain, promoting a sense of well-being and reducing anxiety.
  • Safe Usage with Suboxone: In many cases, SSRIs and SNRIs can be used safely in combination with Suboxone, but careful monitoring is necessary to avoid potential interactions.


  • Mechanism of Action: Buspirone works on serotonin and dopamine receptors, providing anxiolytic effects without causing sedation.
  • Advantages for Anxiety Treatment: It does not lead to significant physical dependence, making it an appealing option for those with a history of substance use disorders.
  • Safe Usage with Suboxone: Buspirone is generally considered safe to use with Suboxone, but healthcare professionals should closely monitor patients for any adverse reactions.


  • How Hydroxyzine Works for Anxiety: Hydroxyzine is an antihistamine that can also act as an anxiolytic by affecting certain neurotransmitters in the brain.
  • Potential Benefits and Considerations: It is an option for short-term anxiety relief, but its sedative effects should be taken into account.
  • Safe Usage with Suboxone: While hydroxyzine can be used alongside Suboxone, healthcare providers should be vigilant about potential side effects.

Possible Interactions between Suboxone and Anxiety Medications

Understanding How Drug Interactions Occur

Drug interactions can happen when two or more substances in the body interact in ways that can affect their effectiveness or lead to unexpected side effects. With Suboxone, it’s crucial to be cautious when adding anxiety medications to the treatment regimen. Some anxiety medications may impact the metabolism of Suboxone or enhance its effects, potentially leading to adverse reactions. Healthcare professionals should carefully assess the risks and benefits of combining medications for each individual.

Potential Risks and Complications

Combining certain anxiety medications with Suboxone can result in respiratory depression, sedation, and an increased risk of overdose. Benzodiazepines, for instance, can have dangerous interactions with Suboxone, potentially leading to respiratory suppression and life-threatening consequences. It is essential for patients to inform their healthcare providers about all the medications they are taking, including over-the-counter medications and herbal supplements, to minimize the risk of harmful interactions.

Monitoring for Adverse Effects

Regular monitoring is essential for individuals using both Suboxone and anxiety medications. Healthcare providers will assess the patient’s response to the combined treatment, looking for signs of adverse reactions. Patients should be vigilant about any unusual symptoms or side effects and report them promptly to their healthcare professionals. Open communication and active involvement in the treatment process can help ensure safe and effective anxiety management while using Suboxone.

Important Points to Remember:

  • Transparency with Healthcare Providers: Be honest and open about all medications and substances used to enable accurate assessment and safe prescribing.
  • Regular Check-ups: Attend scheduled appointments with healthcare professionals to monitor progress and make any necessary adjustments to the treatment plan.
  • Adherence to Prescriptions: Follow medication instructions carefully and avoid altering doses without medical approval.

Anxiety Medications Safe with Suboxone

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are widely used to treat various anxiety disorders, such as generalized anxiety disorder and social anxiety disorder. They are considered safer to use with Suboxone compared to other classes of anxiety medications due to their lower risk of respiratory depression and central nervous system depression. Healthcare providers often prescribe SSRIs as the first-line treatment for anxiety disorders in individuals on Suboxone.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs are another class of antidepressants frequently used for anxiety treatment. They work similarly to SSRIs but also affect norepinephrine levels in the brain. SNRIs may be considered safe to use with Suboxone, but healthcare providers should closely monitor patients for any potential interactions or adverse effects.


Buspirone is a non-addictive anxiolytic medication often prescribed for generalized anxiety disorder. Since it does not significantly interact with opioid receptors, it is generally considered safe to use alongside Suboxone. Buspirone’s unique mechanism of action makes it a valuable option for anxiety management in individuals with a history of opioid addiction.


Hydroxyzine, an antihistamine with anxiolytic properties, is occasionally prescribed for short-term anxiety relief. While it can be used with Suboxone, healthcare providers should be cautious about its sedative effects, especially when combined with other medications with similar side effects.

Key Considerations:

  • Individual Variability: Responses to medications can vary significantly from person to person, and not all patients may tolerate certain anxiety medications well while on Suboxone.
  • Combination Therapy: Healthcare providers will carefully select anxiety medications based on the patient’s specific needs and potential interactions with Suboxone.

Anxiety Medications to Avoid with Suboxone


Benzodiazepines are a class of medications commonly used for anxiety and sleep disorders. However, their use with Suboxone can be extremely dangerous due to the risk of respiratory depression, which can be life-threatening. Combining benzodiazepines with Suboxone can also lead to sedation, dizziness, and impaired cognitive function. Healthcare providers generally avoid prescribing benzodiazepines to individuals on Suboxone, opting for safer alternatives.


Barbiturates are another class of sedative medications that act on the central nervous system. They are rarely used for anxiety management today due to their high risk of overdose and potential for addiction. When combined with Suboxone, barbiturates can lead to severe respiratory depression and even coma. Healthcare providers avoid using barbiturates in patients taking Suboxone.

Other Opioids

Using other opioids alongside Suboxone is not recommended as it can lead to dangerous interactions and increase the risk of overdose. Suboxone contains buprenorphine, a partial opioid agonist, which can compete with other opioids for opioid receptors in the brain. Combining multiple opioids can lead to unpredictable effects and respiratory suppression. Healthcare providers prioritize using non-opioid anxiety medications in individuals on Suboxone.

Safe and Effective Alternatives:

  • Non-Opioid Medications: Consider using non-opioid medications such as SSRIs, SNRIs, buspirone, or hydroxyzine for anxiety management in individuals on Suboxone.
  • Therapy and Counseling: Explore behavioral therapies and counseling as complementary approaches to manage anxiety without introducing additional medications.

Consulting Healthcare Professionals

Importance of Medical Guidance

Seeking medical guidance from healthcare professionals is essential when managing both opioid addiction and anxiety. Healthcare providers have the expertise to assess the individual’s medical history, current conditions, and potential interactions between medications. They can develop an individualized treatment plan that optimizes both opioid addiction treatment and anxiety management.

Expertise in Medication Management

Healthcare professionals, including doctors, psychiatrists, and addiction specialists, are knowledgeable about various anxiety medications and their potential interactions with Suboxone. They can prescribe the most suitable anxiety medication based on the patient’s specific needs, ensuring the highest level of safety and efficacy.

Individualized Treatment Plans

Every individual’s circumstances are unique, and there is no one-size-fits-all approach to anxiety management with Suboxone. Healthcare providers will consider the patient’s medical history, severity of anxiety symptoms, and response to previous medications to tailor a personalized treatment plan that accounts for potential risks and benefits.

Key Considerations during Consultations:

  • Honesty about Medications: Be transparent with healthcare providers about all medications, including Suboxone, taken to avoid potential drug interactions.
  • Communication of Concerns: Share any concerns or questions about anxiety management with Suboxone to enable informed decision-making.

Discussing Anxiety Symptoms and Treatment Options

Identifying Anxiety Symptoms

It’s crucial for individuals to recognize the symptoms of anxiety, which can vary from person to person. Common symptoms include excessive worrying, restlessness, difficulty concentrating, irritability, muscle tension, and sleep disturbances. Identifying these symptoms and discussing them with healthcare providers can lead to accurate diagnosis and appropriate treatment.

Exploring Non-Medication Approaches

In addition to anxiety medications, non-medication approaches can be beneficial in managing anxiety for individuals on Suboxone. Behavioral therapies such as cognitive-behavioral therapy (CBT), exposure therapy, and mindfulness-based techniques have shown efficacy in treating anxiety disorders. These therapeutic approaches can complement medication use and provide valuable coping strategies.

Collaborative Decision-Making

Patients should actively participate in their treatment plan and collaborate with healthcare providers in decision-making. Discussing treatment preferences, concerns, and goals can help healthcare professionals tailor the most suitable anxiety management approach. A collaborative approach fosters trust and empowers patients in their journey towards better mental health.

Non-Medication Techniques to Consider:

  • Cognitive-Behavioral Therapy (CBT): Identify and challenge negative thought patterns and learn coping strategies for anxiety.
  • Exposure Therapy: Gradual exposure to anxiety triggers in a safe environment to reduce fear and anxiety reactions.
  • Mindfulness-Based Techniques: Practice mindfulness to cultivate present-moment awareness and reduce anxiety.

Individualized Approach to Medication

Personalizing Anxiety Treatment

No single anxiety medication works for everyone, especially when combined with Suboxone. Healthcare providers consider individual factors such as age, medical history, previous treatment responses, and lifestyle when selecting an anxiety medication. This personalized approach increases the likelihood of finding an effective and safe medication regimen.

Considering Medical History and Suboxone Use

Medical history plays a crucial role in medication selection and dosing. Individuals with certain medical conditions may have limitations or contraindications for specific anxiety medications. Additionally, healthcare providers carefully assess the impact of Suboxone on anxiety treatment and vice versa to avoid potential complications.

Monitoring Progress and Adjustments

Once an anxiety medication is prescribed, healthcare providers regularly monitor the individual’s progress. They assess the medication’s effectiveness, any side effects, and interactions with Suboxone. Adjustments to the dosage or medication may be made if needed to achieve optimal anxiety management.

Key Factors in Individualized Treatment:

  • Patient’s Age and Health Status: Considerations differ for children, older adults, and those with specific health conditions.
  • Tolerance and Sensitivity: Individual responses to medications can vary, and dosage adjustments may be necessary.

Alternative Anxiety Management Techniques

Therapy and Counseling

Therapy and counseling are essential components of anxiety management, especially for individuals on Suboxone. Cognitive-behavioral therapy (CBT) is a widely recognized approach that helps individuals identify negative thought patterns and develop coping strategies. Additionally, counseling provides a safe space to explore emotions and develop healthier coping mechanisms, contributing to overall well-being.

Mindfulness and Meditation

Mindfulness and meditation practices can be highly beneficial in reducing anxiety symptoms. Mindfulness involves being fully present and aware of one’s thoughts and emotions without judgment. Meditation techniques, such as deep breathing exercises and guided imagery, can help individuals relax and alleviate anxiety. Integrating mindfulness into daily life can complement anxiety medication and promote a more balanced mental state.

Physical Exercise and Relaxation Techniques

Physical exercise is a natural and effective way to reduce anxiety. Engaging in regular exercise releases endorphins, which act as natural mood lifters. Activities such as walking, yoga, and tai chi can be particularly helpful for individuals on Suboxone, providing physical and mental benefits. Additionally, relaxation techniques such as progressive muscle relaxation can help alleviate tension and anxiety.

Non-Medication Strategies for Anxiety Management:

  • Cognitive-Behavioral Therapy (CBT): Learn coping skills and challenge negative thought patterns through therapy.
  • Mindfulness and Meditation: Practice present-moment awareness to reduce anxiety and stress.
  • Physical Exercise: Engage in regular physical activity to release endorphins and improve overall well-being.


In conclusion, finding safe and effective anxiety medication while on Suboxone requires careful consideration and collaboration with healthcare professionals. SSRIs, SNRIs, buspirone, and hydroxyzine are generally considered safe options, while benzodiazepines, barbiturates, and other opioids should be avoided due to potential risks. Non-medication approaches, such as therapy and mindfulness practices, can also be valuable in anxiety management. Through individualized treatment plans and open communication with healthcare providers, individuals can achieve successful anxiety management while safely using Suboxone for opioid addiction.

Frequently Asked Questions (FAQs)

1. Can I take anxiety medication while on Suboxone for opioid addiction treatment?

Yes, you can take anxiety medication while on Suboxone, but it requires careful consideration and medical supervision. Some anxiety medications may interact with Suboxone, leading to adverse effects, so it is essential to discuss your specific situation with a healthcare professional.

2. What are the risks of combining benzodiazepines with Suboxone?

Combining benzodiazepines with Suboxone can be extremely dangerous as it can lead to respiratory depression and overdose. Benzodiazepines are central nervous system depressants, and when used together with Suboxone, which is also a depressant, the effects can be amplified, posing life-threatening risks.

3. Are there any non-medication alternatives for managing anxiety while on Suboxone?

Yes, several non-medication alternatives can complement anxiety management while on Suboxone. Behavioral therapies like cognitive-behavioral therapy (CBT) and mindfulness practices, as well as physical exercise and relaxation techniques, can be effective in reducing anxiety symptoms.

4. Can I use hydroxyzine for anxiety while on Suboxone?

Hydroxyzine is an antihistamine with anxiolytic properties and is considered one of the safer options for anxiety management while on Suboxone. However, it is essential to discuss its use with your healthcare provider to ensure it is appropriate for your specific needs.

5. What should I do if I experience adverse effects from anxiety medication while on Suboxone?

If you experience any adverse effects from anxiety medication while on Suboxone, you should immediately contact your healthcare provider. They will assess your symptoms and determine whether adjustments to the medication or treatment plan are necessary.

6. Is it safe to take multiple anxiety medications while on Suboxone?

Combining multiple anxiety medications while on Suboxone can increase the risk of drug interactions and adverse effects. It is crucial to work closely with a healthcare provider to avoid potential complications and ensure safe and effective anxiety management.

7. Can anxiety medication interfere with my Suboxone treatment for opioid addiction?

Certain anxiety medications can interact with Suboxone and impact its effectiveness. Healthcare providers carefully assess potential interactions to develop a treatment plan that addresses both anxiety and opioid addiction without compromising safety.

8. How long does it take for anxiety medication to start working while on Suboxone?

The time it takes for anxiety medication to start working can vary depending on the specific medication and individual response. Some medications may take several weeks to reach their full effect, while others may provide more immediate relief.

9. Can Suboxone worsen anxiety symptoms?

Suboxone itself is not known to worsen anxiety symptoms. However, some individuals may experience increased anxiety during their opioid addiction treatment due to various factors. It is essential to discuss any changes in anxiety symptoms with your healthcare provider to determine appropriate management.

10. What precautions should I take when using anxiety medication with Suboxone?

When using anxiety medication with Suboxone, it is crucial to follow your healthcare provider’s instructions carefully. Be transparent about all medications you are taking and report any unusual symptoms or side effects promptly. Regular check-ups and open communication with your healthcare provider are essential for safe and effective anxiety management while on Suboxone.