Social Anxiety Disorder (SAD) Treatment: Medications and Therapies
Prescription Medications
Mental health professionals often recommend that people with SAD start a prescription medication and participate in different types of psychotherapy. Studies have shown that these two approaches together can improve long-term outcomes in people with SAD.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are considered first-line treatment for SAD because of their efficacy and mild side effect profile, which have been demonstrated in clinical trials. This class of medication works by blocking the reuptake (absorption) of serotonin in the brain, leaving more serotonin to be available to help alleviate anxiety and mood symptoms.
- SSRIs used to treat SAD include:
- Paxil (paroxetine)
- Luvox (fluvoxamine)
- Zoloft (sertraline)
- Lexapro (escitalopram)
- Celexa (citalopram)
- Prozac (fluoxetine)
More than 20 placebo-controlled trials have shown that SSRIs are highly effective in the treatment of SAD. However, they can cause side effects, including headaches, gastrointestinal issues, insomnia, fatigue, sexual side effects, and initial anxiety.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Another class of medications called SNRIs target not only serotonin but also the neurotransmitter norepinephrine. Norepinephrine is important for attention and other cognitive functions, energy, and mood.
- SNRIs used to treat SAD include:
- Effexor XR (venlafaxine extended-release)
- Cymbalta (duloxetine)
- Pristiq (desvenlafaxine)
Side effects from these medications may include initial increases in anxiety, insomnia, restlessness, possible sexual dysfunction, and headaches.
Therapies
Exposure Therapy
During exposure therapy for social anxiety, you’re gradually presented with the situation that causes you feelings of anxiety, with exposure to increasingly anxiety-provoking situations. Your therapist will then help you identify ways to manage your fear. This exposure may be virtual or in person.
Cognitive Restructuring
In cognitive restructuring, you work with a mental healthcare provider to find the source of your negative thought patterns. Then, you can explore ways to redirect your thoughts so they can take another path. This may help reduce the impact and frequency of negative thoughts.
Social Skills Training
The goal of social skills training is to work on specific behaviors that you may struggle with in social situations that cause stress. This may help improve the way you act in a social situation, such as being able to have a conversation at a busy restaurant.
Interpersonal Therapy
Interpersonal therapy is a psychodynamic therapy that has been used for depression and is being adapted for patients with SAD. It uses role-playing and other techniques to improve your ability to interact and socialize with other people.
Complementary and Alternative Medicine
- Plant medicines, including herbal teas, have long been cited as natural ways to induce calm. Despite popular use, only certain types of plant medicines have been thoroughly evaluated in clinical trials for helping with SAD.
- More recently, people have been using cannabidiol, or CBD, from the hemp plant to ease anxiety. Some research has shown that it may be effective for social anxiety, but this compound has not been comprehensively studied.
Lifestyle Changes
Managing SAD requires commitment to treatment. It’s also important to follow a healthy lifestyle. Anxiety symptoms can be triggered or worsened by certain lifestyle choices.
- Consider changing up your habits to include:
- Spending more time outside
- Eating more fruits, vegetables, and protein-rich foods
- Talking to loved ones (under non-stressful conditions)
- Keeping a regular sleep schedule
- Drinking more water
A Word from Verywell
Starting a new social anxiety disorder treatment can feel very overwhelming. Be sure to raise any questions you might have with your healthcare provider. Since there are many different types of medications and therapy approaches, it’s OK if the first method you try doesn’t work. Your provider will work to continue evolving your symptom management plan to find the right treatment for you.
Remember that medications and therapy take several weeks to start showing improvement, so it’s important to be patient. However, if your symptoms worsen or you experience side effects, reach out to your healthcare provider right away.
