Which Medications Are Used to Treat Social Anxiety Disorder?

A List of Medications for SAD

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Several different types of medications are prescribed to treat social anxiety disorder (SAD). Each has its advantages and disadvantages depending on your particular situation.

Meta-analyses of the effectiveness of medication in the treatment of SAD have found a small to medium-sized effect size for this type of treatment—with all of the following categories of medications showing improvements.

This means that several different types of medication can be helpful in improving symptoms of social anxiety disorder, and that one may be a useful form of treatment for you.

Benzodiazepines

Benzodiazepines alleviate the symptoms of anxiety by slowing down the central nervous system. Benzodiazepines may cause sedation and cognitive side effects, and have the potential to become habit-forming, and therefore are not used as the first line of treatment for SAD.

Beta Blockers

Beta blockers are usually taken prior to an anxiety-inducing event, such as a performance to alleviate symptoms of anxiety. Beta blockers are useful in situations that require mental sharpness, because they do not have adverse effects on cognitive ability as can be true for benzodiazepines.

  • Inderal (propranolol)
  • Tenormin (atenolol)

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs were once considered the most effective treatment for social anxiety disorder; however these medications carry with them the risk of serious side effects if dietary and medication guidelines are not followed.

Today, MAOIs are not usually used in the treatment of SAD, unless there is reason to believe that they will be more helpful than other medications (such as a family history of good results).

In fact, that 2014 meta-analysis found that phenelzine (brand name Nardil) was the most effective form of pharmacotherapy for social anxiety disorder, so don't count the MAOIs out as a potential form of treatment that may be prescribed by your doctor.

  • Nardil (phenelzine)
  • Parnate (tranylcypromine)
  • Marplan (isocarboxazid)

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are the first line of treatment for SAD due to their tolerable side effects and ease of administration. Due to the potential for withdrawal effects, SSRIs should always be tapered when ending treatment.

That 2014 meta-analysis found paroxetine (brand name Paxil) to be the second most effective form of medication treatment for social anxiety disorder.

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs are a class of antidepressants used in the treatment of anxiety that act on the neurotransmitters serotonin and norepinephrine. Venlafaxine extended release (brand name Effexor) was found to be the third most effective type of medication for SAD in that 2014 meta-analysis.

Other Anxiety Medications

If you are not sure of your treatment options, talk to your doctor about the potential use of medication for your particular situation.

Source:

Bezchlibnyk-Butler KZ, Jeffries, JJ, eds. Clinical Handbook of Psychotropic Drugs. Toronto, Canada: Hogrefe & Huber; 2003.

Davis ML, Smits JA, Hofmann SG. Update on the efficacy of pharmacotherapy for social anxiety disorder: a meta-analysis. Expert Opinion on Pharmacotherapy. 2014;15(16):2281-2291. doi:10.1517/14656566.2014.955472.

Mayo-Wilson E, Dias S, Mavranezouli I, et al. Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry. 2014;1(5):368-376. doi:10.1016/S2215-0366(14)70329-3.

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