Social anxiety disorder cannot be cured. Medications are available and have been found to be helpful for some people. Medications sometimes will allow a person to receive more benefit from behavioral therapy. Some of the considerations to consider before beginning medication are:
• The severity of symptoms
• Other medications you may take
• Your current physical health
A medical doctor or a psychiatrist must prescribe medications. Many times the prescribing doctor will work as a member of a team, which can include psychologists, therapists, counselors or social workers. There are a few different types of medication currently prescribed for social anxiety:
Antidepressants have been found to be effective in treating anxiety disorders. These medications do require at least four to six weeks of treatment in order to determine their effectiveness. Patients must be willing to try medications for this period of time in order to allow them to work.
Types of Antidepressants
SSRIs are a type of antidepressant medication. Selective Serotonin Reuptake Inhibitors change the level of serotonin in the brain. Serotonin is a neurotransmitter that helps brain cells communicate with one another. These medications are started at a low dose and increased slowly to determine the correct dosage.
Common SSRIs prescribed for social anxiety disorder include:
• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Escitalopram Oxalate (Lexapro)
• Paroxetine (Paxil)
• Citalopram Hydrobromide (Celexa)
Side effects from these medications can include nausea or jumpiness; however, these side effects normally disappear within a few weeks. SSRIs have fewer side effects than older, more traditional antidepressants. Sexual dysfunction is also sometimes a side effect of SSRIs. Adjusting dosage can normally help this.
Tricyclics have been found to be effective in treating many different types of anxiety (except OCD). They are started at a low dose and increased slowly to determine the most effective dose.
Side effects include dizziness, drowsiness, dry mouth and weight gain.
Common trycyclics used for anxiety disorders:
• Impramine (Tofranil)
• Clomipramine Hcl (Anafranil)
MAOIs are another type of antidepressants and are older than SSRIs and Trycylcics. The most common ones prescribed for anxiety include
• Tranylcypromine (Parnate)
• Isocarboxazid (Marplan)
One disadvantage to this type of medication is the interaction with certain types of food, such as cheese and red wine. Additionally, patients cannot take some medications including over the counter pain medications (Advil, Motrin and Tylenol), cold medications, certain birth control bills, allergy medications and some herbal supplements. Interactions with these food and medications can cause blood pressure to increase to dangerous levels.
In addition, MAOIs interfere with SSRIs and can cause hallucinations, confusion, muscle stiffness, seizures or changes in blood pressure and heart rate.
There are some medications specifically known as anti-anxiety medications. Side effects include drowsiness. Sometimes people will need higher doses as time goes on. Because of this, these are sometimes used for short periods of time. They also can cause withdrawal symptoms when stopped abruptly.
Anti-anxiety medications used for social phobia are:
Beta-blockers are used to treat the physical symptoms often associated with social anxiety disorder. This type of medication can be helpful if there are specific social situations that cause anxiety and medication can be taken prior to the social encounter to prevent the physical symptoms.
Common Beta-blockers prescribed for anxiety:
• Propranolol (Inderal)
With all medications, you should be closely monitored by a physician and should discuss with your doctor all side effects. In addition, it is important to take medication exactly as prescribed.
Anxiety Disorders, National Institute of Mental Health, 2008
Medications for Anxiety, Helpguide.org
Social Anxiety Disorder, Elizabeth Querna, 2005, US News and World Report