Medication for Social Anxiety & Nervousness

Social anxiety disorder, also referred to as social phobia, is a potentially debilitating condition in which the person has persistent, intense, chronic fear of being watched, judged, embarrassed or humiliated by others. According to WrongDiagnosis.com, 3.7 percent of adults in the United States--over five million Americans--have social anxiety disorder.

Impact

• Social anxiety affects the quality of life, the well being and the health of those whom it afflicts. Some people become wrought with anxiety hours or even weeks before social engagements, they lose sleep and they develop physical symptoms such as headaches, nausea, diarrhea and muscular pain. In severe cases, social anxiety is disabling, prohibiting work.

Co-occurring Disorders

• Social anxiety often occurs as an associated feature of other illnesses or disorders, including generalized anxiety disorder, panic disorder, major depression, dysthymic disorder, schizophrenia, pervasive developmental disorder and body dysmorphic disorder.

Therapy

• Cognitive-behavioral therapy (CBT), which focuses on altering the thoughts, attitudes and beliefs of the patient, has been found to be an effective treatment for social anxiety. CBT used in conjunction with medications has been found to be the most effective treatment.

SSRI Medications

• Selective serotonin reuptake inhibitors (SSRIs) such as paroxotine, sertraline, fluvoxamine and fluoxetine, are generally the first-line medications used for social anxiety. SSRIs increase the availability of the neurotransmitter serotonin by inhibiting its reuptake into presynaptic cells.

SNRI Medications

• Seratonin and norepinephrine reuptake inhibitors (SNRIs) are also used as first-line medications for social anxiety. In a similar manner as SSRIs, SNRIs bind with receptor sites and prevent reuptake of neurotransmitters, increasing the availability of serotonin and norepinephrine in the brain.

Anti-anxiety Medications

• Benzodiazepines are anti-anxiety medications that are often effective with social anxiety. However, they are commonly prescribed on only a temporary basis for social anxiety because benzodiazepines are habit-forming and have sedative effects, and users often have to increase dosages as they develop a toleranfce for the medication. In addition, these medications frequently cause undesirable side effects such as cognitive impairments, deficits in memory and loss of sex drive.