Paxil, Zoloft, and Effexor are FDA-approved medications for social anxiety disorder. Off-label drugs may also help, but treatment may depend on the severity of your symptoms. Relief is possible.
When persistent worry and recurring fear interfere with your quality of life, you may receive an anxiety disorder diagnosis.
Social anxiety is one of four main types of anxiety disorder. Its characteristics include an intense preoccupation with social situations and personal interactions. In some instances, you may fear being judged or observed or worry that you won’t behave according to social expectations.
Social anxiety goes beyond being shy. It does not mean you don’t like people or that you cannot establish quality relationships. Instead, you may feel anxious about specific situations, like giving a presentation, eating in front of others, meeting someone new, or walking in a public place.
Treatment often effectively reduces the effect that social anxiety has on your self-concept, relationships, and quality of life in general.
A mental health care professional can provide an accurate diagnosis and offer treatment options depending on the intensity and frequency of your symptoms.
Psychotherapy is the first line of treatment for social anxiety. If symptoms persist or are severe, your healthcare professional may recommend anxiety medications.
Social anxiety medications: The list
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Not all medications used to treat anxiety have indications for social anxiety symptoms. Also, not all medications used for social anxiety have Food and Drug Administration (FDA) approval for this purpose. Healthcare professionals may prescribe some drugs off-label, meaning they may reduce your symptoms even if manufactured to treat other conditions.
Depending on your medical history and current symptoms, a healthcare professional may treat social anxiety with the following medications:
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs act on your levels of serotonin, a mood-regulating hormone. They are the first line of pharmaceutical treatment for depression and are also effective for social anxiety symptoms.
Your healthcare professional may start your social anxiety treatment with an SSRI because they often have fewer side effects and complications than other anti-anxiety medications, like benzodiazepines.
Possible side effects of SSRIs for social anxiety may include:
jitteriness
nausea
headaches
changes in appetite
changes in weight
tremors (shaking)
diarrhea or constipation
fatigue
dry mouth
sexual dysfunction
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SNRIs also help treat depression and may help reduce social anxiety symptoms. They also act on serotonin levels but affect norepinephrine as well. This neurotransmitter and hormone plays an important role in your stress response and alertness.
Your healthcare professional may switch you to an SNRI if your symptoms do not improve with SSRIs.
Sometimes, if you do not see improvement with SSRIs or SNRIs or tolerate their side effects, a healthcare professional may recommend other medications, like anticonvulsants.
Pregabalin (Lyrica) is not indicated for anxiety symptoms, but research suggests it may reduce symptoms of social anxiety disorder in some people.
Benzodiazepines are anti-anxiety medications typically used as a short-term treatment. They are popularly known as tranquilizers because they induce a sedation state. Some people take them to treat insomnia and seizures.
Long-term use of benzodiazepines has associations with chemical dependence and cognitive decline. This means your body may adapt to the dosage and need more to get the same effect. It may also cause your body to experience severe symptoms when you stop taking the drug.
Your healthcare professional may prefer you use other medications before recommending benzodiazepines for a short time.
Possible benzodiazepines for social anxiety include:
Side effects of these benzodiazepines may include:
headaches
nausea
vomiting
diarrhea
tremors
confusion
drowsiness
respiratory problems
Monoamine oxidase inhibitors (MAOIs)
Also a type of antidepressant, MAOIs were one of the first off-label medications that showed promise for treating social anxiety disorder. However, severe side effects and an increased chance of complications for some people has meant that healthcare professional may no longer recommend them as a first-line treatment option.
Summary
Three FDA-approved medications for social anxiety disorder are venlafaxine (Effexor), paroxetine (Paxil), and sertraline (Zoloft). Other off-label drugs may also help.
Antidepressants are the first line of treatment for anxiety disorders. They may help improve your mood by balancing neurotransmitter and hormone production.
Social anxiety treatment may depend on the intensity of your symptoms and your tolerance to some of the common side effects of these medications. But symptom relief is possible.
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