There are times when treatments for social anxiety, such as cognitive behavioral therapies and other psychological methods, do not work. In this situation a patient’s doctor may recommend medication to help alleviate social anxiety symptoms.
Most medications are given singularly whereby a patient uses one drug at a time until their symptoms are under control. However, there are times when doctors may employ more than one medication to reduce severe symptoms and get a better control on the anxieties.
Social anxiety medications are used based on the patient’s ability to tolerate them over a long period of time and their ability to treat the symptoms. Antidepressant medications are prescribed for social anxiety and can be used alone or in combination with other types of drugs to stop symptoms. Some examples of these include:
· Effexor – side effects include impotence, other sexual malfunctions, nausea, anorexia, dry mouth, vision problems, sweating and constipation; doses are recommended at 75 to 225mg twice a day with food; no known drug interactions have yet been found
· Nardil – side effects include dizziness, constipation, drowsiness, headaches, constipation, low blood pressure when getting up, liver conditions, troubles sleeping, digestive problems, increased weight, water gain and sexual problems; doses are 15 to 90mg daily; some drugs and foods that should be avoided whilst taking Nardil and for 2 weeks after completing the treatment include excessive caffeine, beer, cheeses, chocolate, processed salamis/pepperonis/bologna, fava beans, liver, meat extracts, pickled/aged/smoked/fermented/poorly stored fish/dairy/meat products, wine, sauerkraut, yeast extracts, yogurt, appetite reducers, amphetamines, antidepressants (exact or related), inhalants (asthma), hay fever/sinus/cold medications, decongestants (any variety), products containing l-tryptophan, and stimulant medications (EpiPen, Ritalin, etc.)
· Moclobomide – has no side effects for more most people, but is only useful for very mild social anxiety; doses are generally 10 to 150mg taken as directed by the prescribing doctor per day; there are currently no known drug interactions
· Bupropion – side effects include dry mouth, agitation, insomnia, nausea, tremors, constipation and insomnia; doses generally start at 150mg, 3 times/day; there are not many drug interactions, but those to be avoided include prochlorperazine, chlorpromazine and other antipsychotic drugs (phenothiazine varieties)
· Prozac – one of the most commonly used, especially for males because it has limited side effects like drowsiness; doses start at 20mg/day; drugs that should not be taken during the use of or for 3 weeks after finishing the treatment include MAO inhibiting medications, lanoxin and coumadin
· Sertraline – side effects include apathy, drowsiness and sexual problems; doses are 25 to 200mg daily; drugs that should be avoided during and for at least 2 weeks after finishing treatment include SSRI’s, cimetidine, pimozide, warfarin and monoamine oxidase inhibitors or MAOI’s due to the risk of serious blood pressure problems, heart function problems and potential death
· Paxil – side effects include yawning, sleeping problems, drowsiness, sedation, nausea, increased weight, vomiting, apathy, dry mouth and sexual problems; doses are generally at the discretion of the doctor and based on varied health and other factors; drug interactions that should be avoided include MAO inhibiting drugs, astemizole, thioridazine, sibutramine, terfenadine, phentermine, antiarrhythmics, cimetidine, digoxin, clozapine, natural/herbal remedies, lithium, procyclidine, nefazodone, thrombolytic medications (TPA’s, anticoagulants), antidepressants (SSRI), trazodone, theophylline, antidepressants (tricyclics), migraine medications, tryptophan, aspirin (low doses), venlafaxine, diazepam, antihistamines, anti-seizure medications, sleeping pills, muscular relaxants, pain medication (narcotic), psychiatric drugs, sedatives, paroxetine, tranquilizers, dofetilide, quinidine, procainamide, , procainamide, sotalol and sparfloxacin due to their potentially fatal effects
· Citalopram – side effects include increased or decreased energy, sedation, apathy and sexual problems; doses are generally 20 to 40mg per dose as per instructions from the prescribing doctor; drugs to avoided during the use of and for 3 weeks after using citalopram include MAO antidepressants, selegiline, fenfluramine, dexfenfluramine and tryptophan which due to their dangerous effects and potentials when combined.
· Escitalopram – side effects include increased or decreased energy, sedation, apathy and sexual problems; doses are 10 to 20mg daily; drugs to be avoided during use and for 3 weeks after include MAO antidepressants, selegiline, fenfluramine, dexfenfluramine, tryptophan, aspirin and anti-inflammatory/bleeding medications (anti-steroidal)
· Duloxetine – side effects include nausea, constipation, dry mouth, appetite loss, fatigue, dizziness, drowsiness, blurry vision, increased sweating, itching and rashes; doses are prescribed at varied levels at the discretion of the prescribing doctor; drugs to be avoided during and for 3 weeks after using duloxetine, including MAO antidepressants, thioridazine, herbal remedies, ciprofloxacin, cimetidine, heart rhythm drugs, paroxetine, fluoxetine, fluvoxamine, fluoxetine, thrombolytic medications, aspirin, antihistamines, anti-anxiety medications, anti-seizure medications, sleeping pills, muscular relaxants, pain medications (all types), psychiatric drugs, tranquilizers, cough/cold products and anti-fever drugs due to potentially dangerous results
Medications used for social anxiety vary greatly in type, dosage, side effects and drug interaction. However, it is important to never administer prescription drugs without the approval and guidance of a medical doctor, or to combine these with other drugs.
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