Do you suffer from social anxiety? If this is the case, you are not alone. Nearly 12.1% of US adults are estimated to have social anxiety disorder (or social phobia), a condition that can make daily activities impossible. There are, thankfully, treatments for social anxiety, including prescription medication. In this article, we’ll look at the best medications for social anxiety available for treating social anxiety and social phobia, as well as their side effects and benefits.
What Exactly Is Social Anxiety Disorder?
SAD, formerly known as social phobia, can be defined by persistent distress about social situations that are out of proportion to the actual risks. These anxieties have a significant impact on a person’s daily functioning and are not the result of a medical condition, medication, or substance abuse.
Social anxiety is different from other types of anxiety in that it is connected with social interactions and fears of being negatively judged, embarrassed, or humiliated. Although this sounds similar to shyness, the difference between the two is that SAD has a much greater impact on an individual’s quality of life.
How common is Social Anxiety nowadays?
The second most commonly diagnosed mental health disorder, social anxiety disorder, affects nearly 15 million American adults. Social anxiety disorder typically begins in childhood or adolescence, but it can begin in adulthood as well.
Despite the availability of effective treatments, only 5% of people suffering from social phobia seek professional assistance. Untreated, social anxiety disorder can cause significant impairment in work, school, and social functioning, lowering a person’s overall quality of life.
What are the negative effects of social anxiety disorder?
Social anxiety disorder can have negative effects on one’s life, such as:
- Low-income levels due to work difficulties
- Poor education due to school difficulties
- The difficulty establishing romantic relationships
- It is difficult to form close friendships.
- Self-esteem issues
How Does Medication Help in the Treatment of Social Anxiety?
SAD-related negative symptoms can be addressed with medications. They can significantly improve social, educational, and professional functioning when used in conjunction with therapy. Generally, best medications for social anxiety target anxiety symptoms, whereas therapy teaches people how to deal with difficult situations.
SAD cannot be “cured,” but it is possible to achieve “remission,” which means that symptoms no longer exist. Some people may require SAD treatment for years before experiencing remission, while others may only require it for a few months.
Social Anxiety Antidepressants
Certain antidepressants are recommended as first-line best medications for social anxiety. According to research, the neurochemicals serotonin, norepinephrine, and dopamine play an essential part in mood and anxiety, and antidepressants work to increase their activity in the brain.
Many people have misconceptions about how antidepressants affect them. If an individual is a good fit for the antidepressant, he or she should experience mild to no side effects and symptom relief. Antidepressants typically take four to six weeks to take effect. If you’re wondering how to get antidepressants, talk to your primary care physician or a mental health professional.
Prescription Medications Approved by the FDA for Social Anxiety
Depending on the severity of your symptoms, you may be prescribed one of several best medications for social anxiety.
Selective serotonin Reuptake Inhibitors (SSRIs)
By increasing serotonin availability in the brain, selective serotonin reuptake inhibitors (SSRIs) may improve mood and anxiety. They do this by connecting to the serotonin transporter (SERT) protein and inhibiting serotonin recycling. Some SSRIs are FDA-approved for the treatment of SAD and are thus frequently prescribed by professionals. Certain SSRIs that are not specifically FDA-approved may, however, be used off-label. SSRIs are typically taken daily. Doses can be increased based on tolerability and efficacy.
The following SSRIs may be used to treat social anxiety:
- Sertraline (Zoloft)
- Paxil (paroxetine) is a medication.
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Citalopram (Clixa)
SSRIs commonly cause the following side effects:
- Headache
- Vomiting, nausea, and diarrhea
- Dizziness
- Drowsiness
- The mouth is parched.
- Sexual issues, such as low libido
- Changes in appetite
- Nervousness
- Anxiety signs
- Insomnia
SNRIs are selective norepinephrine reuptake inhibitors.
Serotonin-norepinephrine reuptake inhibitors (SNRIs) work by blocking the reuptake of both neurotransmitters to increase serotonin and norepinephrine availability in the brain.5 Some SNRIs, like SSRIs, are approved by the FDA for the treatment of SAD, while others may be used off-label.
SNRIs are typically taken once daily, with doses tailored to the individual. The main difference between SNRIs and SSRIs is that SNRIs target two neurotransmitters, whereas SSRIs target only serotonin. Some patients may prefer or tolerate one more than the other.
The following SNRIs may be used to treat social anxiety:
- Venlafaxine (Effexor)
- Desvenlafaxine (Pristiq)
- Cymbalta (duloxetine) is a medication.
SNRIs commonly cause the following side effects:
- Headache
- Diarrhea, Nausea, and Vomiting
- Dizziness
- Sweating excessively
- Mouth Aridity
- Sexual issues, such as low libido
- Changes in appetite
- Insomnia
MAOIs are monoamine oxidase inhibitors.
MAOIs are antidepressants that increase norepinephrine, serotonin, and dopamine levels in the brain by inhibiting monoamine oxidase, an enzyme responsible for the removal of these neurotransmitters.6
Prescriptions can be taken orally or through patches daily. Furthermore, if other treatments have failed, these medications may be used off-label for social anxiety. MAOIs are rarely prescribed due to their poor tolerability (side effects) and potentially dangerous interactions with other medications, such as antidepressants and foods containing tyramine (aged cheeses, fermented foods, and wine). If you are considering MAOIs, consult your doctor for a complete list of medication, dietary, and beverage restrictions.
MAOIs that may be used off-label to treat social anxiety include:
- Isocarboxazid (Marplan)
- Phenelzine (Nardil)
- Selegiline (Emsam)
- Tranylcypromine (Parnate)
MAOIs commonly cause the following side effects:
- Headache
- Vomiting, nausea, and diarrhea
- Dizziness
- The mouth is parched.
- Sexual issues, such as low libido
- Skin tingling Involuntary muscle jerks
- Skin reaction to the patch
Beta-Blockers
Beta-blockers are FDA-approved for the treatment of heart conditions, but they can also be used as a best medications for social anxiety and anxiety disorders off-label. This work by inhibiting adrenaline, a hormone that contributes to the “fight or flight” response, which can result in stress.7 In practice, beta-blockers can be taken on a daily or as-needed basis. For example, a beta-blocker may be used only in situations where the user experiences increased social anxiety, such as when giving a speech or attending a large event.
The following beta-blockers may be used to treat social anxiety:
- Propranolol (Inderal)
- Tenormin (atenolol) is a medication.
- Metoprolol (Lopressor)
- Nebivolol (Bystolic)
- Bisoprolol (Zebeta)
- Carvedilol (Coreg)
Beta-blockers commonly cause the following side effects:
- Dizziness
- Drowsiness
- I’m feeling dizzy.
- Blood pressure is too low.
- Symptoms of depression
- Having difficulty sleeping
- Hands or feet that are cold
Benzodiazepines
Benzodiazepines are anti-anxiety medications that are used to relieve anxiety symptoms temporarily. These work by increasing the levels of the neurotransmitter GABA, which has a calming and sedative effect.8 Benzodiazepines are used off-label to treat social anxiety disorder, but they can also be used to relieve acute anxiety symptoms.
Unlike antidepressants, which are taken daily, benzodiazepines are only given when symptoms arise and do not help to prevent anxiety. Another issue is that they can lead to tolerance, withdrawal, and physical dependence.8 This risk increases when these medications are used to treat chronically elevated anxiety rather than acute anxiety. Because benzodiazepines are used “as needed,” To avoid benzodiazepine withdrawal, it is critical to consult with your healthcare provider before changing or discontinuing these medications.
Benzodiazepines used to treat social anxiety include the following:
Benzodiazepines commonly cause the following side effects:
- Mental exhaustion
- Sloppy speech
- Drowsiness
- Dizziness
- Memory issues
- Light-headedness
- Unsteadiness (especially in the elderly)
What are the other treatment options and resources for social anxiety disorder?
There are numerous best medications for social anxiety. These can include therapy, group support, and healthy lifestyle choices. Let’s go over these in more detail below.
Therapy
CBT can also be used as a first-line best medications for social anxiety. People are encouraged to focus their attention outward rather than inward during CBT to help reframe their thoughts about social situations. Several studies have found that CBT significantly improves social anxiety symptoms.
The most effective part of CBT, according to the ADAA, involves exposing people to feared social situations (exposure therapy). CBT with exposure therapy is an effective treatment option for a variety of anxiety disorders, including social anxiety disorder.
Combining CBT with medications may help some people manage their social anxiety disorder. A randomized controlled trial found that combining CBT with antidepressants was effective in reducing anxiety symptoms in nearly half of people with social anxiety disorder who had symptoms despite taking medications.
Groups of support
Some people may benefit from support or self-help groups in dealing with this condition. People are encouraged to share their challenges and accomplishments with others who are dealing with similar issues in these settings.
There are both in-person and online support groups. Although internet forums and chat rooms are easily accessible, you should consult your healthcare provider before acting on any medical or mental health advice you receive online.
Lifestyle change
Aerobic exercise, such as running, biking, or swimming, may be beneficial for some people suffering from social anxiety disorder. According to research, combining exercise with other therapies such as CBT or medications can help some people relieve anxiety symptoms. Before beginning an exercise program, consult with your provider about how to do so safely.
Other resources
A helpful brochure describing social anxiety disorder is available from the National Institute of Mental Health.
The United States Department of Veterans Affairs has a screening checklist for people who may be suffering from social anxiety, as well as numerous mental health resources for veterans.
The Substance Abuse and Mental Health Services Administration provides a locator tool to connect people with behavioral health treatment resources in their area.
The National Alliance on Mental Illness has resources to help people understand insurance coverage for mental health treatment.
The Anxiety and Depression Association of America maintains a list of anxiety support groups.
Social Anxiety Support is an online forum where people with social anxiety disorder can connect and share their experiences.
Before starting a New Medication, Here Are Some Questions to consider
It is crucial to discuss the risks, advantages, alternatives, and side effects of a new medication with your healthcare provider before starting it. This enables you to decide for yourself whether or not you think this is a viable option.
Consider consulting with your mental health provider before starting a new social anxiety medication.
- What signs does this medicine try to treat?
- What potential negative effects are there?
- Which adverse effects usually disappear with time?
- Do any long-term or potentially harmful side effects?
- How can I get in touch with you if I have any questions?
- Are there any other options besides this one?
Frequently Asked Questions
What are the best medications for social anxiety?
There is no “best” medication for social anxiety because everyone reacts differently to different medications. Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and beta-blockers are some common medications that may be prescribed.
Is it possible to treat social anxiety with medication?
While medication can help with symptoms of social anxiety, it is not a cure. To help you manage your social anxiety, medication should be used in conjunction with other treatment methods such as cognitive-behavioral therapy (CBT).
What are the most common social anxiety symptoms?
Intense fear, avoidance of social situations, and anxiety or panic attacks in social situations are the most common symptoms of social anxiety. Nausea, sweating, trembling, heart palpitations, and dizziness are some of the other symptoms.
