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Social Anxiety Disorder - Treatment Overview

Medicines

Medicines often used for chronic, severe, or generalized social anxiety disorder include:

  • Selective serotonin reuptake inhibitors (SSRIs), to relieve anxiety. SSRIs are often the first type of medicine used to treat generalized social anxiety disorder.
  • Venlafaxine, a serotonin norepinephrine reuptake inhibitor (SNRI), to help relieve anxiety and depression.
  • Monoamine oxidase inhibitors (MAOIs), to relieve depression and anxiety. MAOIs have potentially serious side effects when they are taken with certain foods (such as some cheeses and red wine).
  • Benzodiazepines, to relieve anxiety. They are fast-acting. But they may be habit-forming and are not generally used in those who have substance abuse problems.
  • Beta-blockers, to reduce anxiety. Beta-blockers are sometimes used to treat physical symptoms of anxiety (such as tremors or rapid heart rate).

Ongoing treatment of social anxiety disorder usually includes continuing psychological counseling and regular checkups to monitor any medicines you may be taking. If professional counseling alone has not reduced your anxiety symptoms, medicines may be added to your treatment.

If your anxiety is triggered by many social situations (generalized), you may need continuous and prolonged treatment with a combination of counseling and medicines. During this time, your doctor will need to monitor your medicines. If one medicine doesn't work for you, you and your doctor may decide you should try another.

Treatment if the condition gets worse

With social anxiety disorder, it is possible to progress from debilitating fear of one social situation to having anxiety about all social encounters (generalized). If this occurs, additional treatment is needed that usually includes adding medicines and increasing the amount of professional counseling you receive.

You may also feel more anxious when you start professional counseling. This is because you are thinking about the situations that cause you fear and anxiety. After the situations have been identified, the fears can be addressed through counseling—especially cognitive-behavioral therapy which includes exposure therapy—gradually exposing you to your fear.

If you are taking medicines to treat social anxiety disorder, you will need regular checkups to monitor the medicines (such as selective serotonin reuptake inhibitors) and their potential side effects. The medicines may cause bothersome side effects that may make your anxiety worse at first. These side effects may get better over time. But if they do not, you may need to take a different medicine.

If social anxiety disorder is left untreated or improperly treated, it can cause debilitating distress that interferes with daily activities. Physical symptoms such as rapid heart rate, blushing, shortness of breath, and dizziness can occur and need to be assessed.

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WebMD Medical Reference from Healthwise

Last Updated: June 13, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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