In general, medication for social anxiety disorder falls into one of three categories: antidepressants, beta blockers or benzodiazepines. A specific class of antidepressants called selective serotonin uptake inhibitors (SSRIs) are typically the first choice prescribed for social anxiety disorder and are favored largely for their safety. Beta blockers are usually used for high blood pressure, but they also can be used to help relieve some of the physical symptoms of anxiety, such as sweating and rapid heartbeat. Benzodiazepines are considered fast acting and effective for severe social anxiety attacks, but they usually are a last resort because of their tendency to become addictive and sedative.
Although SSRIs are antidepressants, they have been shown to function well as a medication for social anxiety disorder. SSRIs work mainly by increasing one’s level of serotonin, a chemical in the brain commonly associated with feelings of well-being. They generally are considered the first choice for people who have a long-term struggle with social anxiety, because they do not have many severe side effects and there is less risk of tolerance or addiction compared to older drugs.
For example, a class of antidepressants called monoamine oxidase inhibitors (MAOIs) used to be considered the most effective drugs for social anxiety before the discovery of SSRIs. MAOIs, however, are commonly criticized for involving too many strict dietary and medication restrictions that could have severe side effects if not followed. SSRIs, by comparison, are considered much safer.
Doctors typically start social anxiety disorder patients with a low dosage of the SSRI, gradually building up to a full dosage. This is because mild side effects such as nausea, headaches and insomnia are common during the first few weeks of treatment. The body must get used to the drug over time.
Beta blockers are effective in relieving outward symptoms of anxiety — sweaty hands, shaking, sweating, rapid heartbeat and more — and are generally best as a short-term, infrequent medication for social anxiety disorder. They work by blocking out adrenaline, so they can be most useful in times directly before one has to enter into an anxious situation. Beta blockers usually work quickly, but they can also be habit-forming. Additionally, beta blockers cannot relieve the actual emotional or psychological struggle of the disorder; they can only relieve the symptoms of it.
Benzodiazepines are rarely recommended as medication for social anxiety disorder unless the person cannot respond to any other drug. They are powerful and fast-acting, and they work by slowing down the entire central nervous system. This often creates a sedative effect that can also damage a person's ability to think properly. Benzodiazepines are also prone to becoming addictive, so they are only rarely prescribed for short-term relief of extremely severe anxiety.
Medication for social anxiety disorder is generally considered to work best alongside therapy and counseling. Most medications for this disorder treat the symptoms of it, not the root of it. Furthermore, in picking a certain brand of medication, it is important that a patient talk personally with a psychiatrist to find the specific medication that works best with his or her situation.