Social anxiety disorder, also known as social phobia, can be helped by a few prescription medications. If your doctor has indicated that you have social anxiety disorder and it is time to consider a medication, then an antidepressant with effects on serotonin can be considered. Serotonergic antidepressants include SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin norepinephrine reuptake inhibitors). SSRIs and SNRIs are considered first when treating social anxiety disorder, after either a failed trial of CBT (cognitive behavioral therapy) or if the social anxiety symptoms are severe.
If the SSRI or SNRI is only partially effective, then you can talk to your doctor about adding a benzodiazepine such as Klonopin (clonazepam). It can take up to 8 weeks for the SSRI/SNRI to take full effect to reduce anxiety. Therefore, adding a benzodiazepine can help to address the anxiety symptoms while the SSRI or SNRI takes effect weeks later. Then when the SSRI or SNRI takes full effect, then the benzodiazepine can be discontinued.
There is another type of social anxiety disorder, called performance anxiety (stage fright). Performance anxiety only occurs in discreet episodes after you expose yourself to performance situations in front of an audience. Hence, you only need a medication on an as-needed basis, as the performance anxiety only occurs when you perform in front of an audience. Beta blockers, such as propanolol, can help to reduce the performance anxiety by blocking the effects of adrenaline, which is released during the fight or flight response when you are performing in front of an audience. So when you take the propranolol, 10mg or 20mg one-hour before your performance, then you can perform without the physical symptoms of anxiety, as the propranolol will block the effects of the adrenaline.
