Social anxiety (social phobia) treatment includes therapy and anxiety medication. Therapy focuses on changing habits and thought processes that trigger social anxiety. Anxiety medication reduces symptoms of anxiety, making it easier to focus on therapeutic treatment and function in social situations.
Treating Anxiety with Antidepressants
Several types of antidepressants are used to treat anxiety. Antidepressants can perform a dual role, as anxiety, depression and other mental disorders often occur together. Two families of antidepressants — SSRIs and SNRIs — are first-choice medications for the treatment of anxiety.
SSRIs and Anxiety Treatment
SSRIs, or selective serotonin reuptake inhibitors, prevent brain cells from reabsorbing the neurotransmitter serotonin. Low levels of serotonin are common in people with symptoms of depression and anxiety disorders. By increasing serotonin levels SSRIs improve mood and reduce anxiety.
Examples of SSRI medication include citalopram, escitalopram, fluoxetine, paroxetine and sertraline. While SSRIs are generally well-tolerated, side effects can occur, including changes in sleep patterns, weight gain, sexual dysfunction, and (in some cases) worsening anxiety symptoms.
SNRIs and the Treatment of Anxiety
SNRIs, or serotonin-norepinephrine reuptake inhibitors treat anxiety in much the same way as SSRIs, but SNRIs also affect brain tissue levels of the neurotransmitter norepinephrine. Side effects of SNRIs are, for the most part, similar to SSRI side effects. Whether SNRIs or SSRIs are used to treat anxiety depends on the individual’s response to antidepressants. Examples of SNRIs include duloxetine and venlafaxine.
Tricyclic Antidepressants and Social Anxiety
Treatment of social anxiety disorder with tricyclic antidepressants may be considered in cases where SSRI or SSRI treatment proves ineffective.
An older family of antidepressants, tricyclic antidepressants are more likely to cause side effects than the newer antidepressants, including sudden drops in blood pressure when standing up. For some people, however, with careful monitoring, tricyclic antidepressants can serve as are viable treatments for social anxiety disorder.
Anti-Anxiety Medications: Benzodiazepine
Antidepressants treat anxiety symptoms effectively, but do not produce immediate symptom relief. Antidepressants require several weeks of treatment before people begin to feel better. Benzodiazepine anti-anxiety medication provides symptom relief faster than antidepressants.
Unfortunately, benzodiazepines cannot treat anxiety over long periods, as the medication can be habit-forming. Benzodiazepines treat anxiety with a sedating effect and by reducing muscle tension. Benzodiazepines may relieve anxiety symptoms until antidepressants begin to work, after which benzodiazepine use is tapered off.
Beta Blockers and Social Phobias
Beta blockers are another short-term treatment for social anxiety disorder. Beta blockers impair adrenaline action, reducing blood pressure, heart rate and shakiness. Beta blockers are not used as a long-term anxiety medication, but can be used to treat isolated increases in social anxiety symptoms, such as just before entering a known anxiety-provoking situation.
Medication for anxiety is often used in combination with social anxiety disorder therapy. The medication helps reduce symptoms of social anxiety so the individual can benefit from therapy. Depending on the severity of social phobia, some individuals may take anti-anxiety medication only for short periods, while others benefit from long-term treatment with antidepressants.
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