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The Best Drugs for Social Anxiety

By Robert DiPardo ; Updated August 14, 2017

According to the National Institute of Mental Health (NIMH), social anxiety is a type of mental disorder that makes a person unreasonably self-conscious in public. People with social anxiety have a strong fear of being judged by others or being embarrassed by what might happen to them in a given social situation. The Adult Anxiety Clinic of Temple University lists public speaking and presenting at meetings as examples of such social situations and goes on to say that social anxiety has a negative effect on performance at work and on personal relationships. According to the Mayo Clinic, selective serotonin reuptake inhibitors (SSRIs) are the best drugs for social anxiety.

Paroxetine (Paxil)

According to Drugs.com, paroxetine is an oral, prescription SSRI medication that has clinically proven effectiveness for the treatment of social anxiety. Patients initially take 20 mg once a day, preferably in the morning, and the treatment regimen usually lasts 12 weeks. It is not clear if paroxetine treatment for social anxiety is useful beyond 12 weeks. The patient’s doctor should gradually decrease the dose of paroxetine when it is time to discontinue therapy. Common side effects associated with paroxetine are nausea, dry mouth, decreased appetite and libido, and abnormal ejaculation, says Drugs.com. It is important to know that short-term clinical trials have shown that paroxetine increased the risk of suicidal thoughts and behavior in patients under the age of 24. For patients beyond the age of 24, this increased risk was not apparent.

Sertraline (Zoloft)

The Mayo Clinic says that sertraline is an oral prescription treatment for social anxiety that falls into the selective serotonin reuptake inhibitor class of medicines. The adult oral dose for social anxiety is 25 mg once a day. This dose may increase, but it should not exceed 200 mg per day. The patient may not begin to feel better until four or more weeks after the start of treatment. Some patients may display agitation, irritability or suicidal thoughts and tendencies while taking sertraline, says the Mayo Clinic. The patient’s doctor should know about these behaviors immediately. Common side effects of sertraline include sour stomach, decreased appetite, diarrhea and trouble sleeping.

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Fluoxetine (Prozac)

According to the U.S. National Library of Medicine (USNLM), fluoxetine is an oral prescription SSRI medication that can treat social anxiety and various other mental conditions. It is available as a capsule, tablet and an oral solution. Doctors prescribe fluoxetine either as a once daily morning dose or as a twice daily morning and noon dose. Patients generally start on a low (10 mg) daily dose, to be increased gradually by the doctor. It is possible that the patient will require four or five weeks of treatment to achieve the full effect of fluoxetine, says the USNLM. When the course of treatment is over, the doctor will gradually decrease the dose so that withdrawal symptoms do not occur. Common side effects of fluoxetine are nervousness, nausea, dry mouth, loss of appetite, weight loss and changes in sex drive or ability. It is important to point out that during clinical trials with fluoxetine, a small number of patients under the age of 24 experienced suicidal thoughts or tendencies.

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