Social Anxiety Medication—A Comprehensive Guide

Social anxiety can strike at the most inconvenient moments—during a big presentation, at a party, or even in a casual conversation. If you’ve experienced these feelings, you’re not alone—about 12.1% of adults in the U.S. have experienced social phobia at some point in their lives.

On the bright side, numerous methods, including medications and non-pharmaceutical solutions, can help manage this condition. To benefit from any regimen, you should learn how it works, what its potential side effects are, and how to apply it properly.

This guide will focus on social anxiety medication options and their potential alternatives to help you deal with this unpleasant condition and get the best treatment quickly.

What Causes Social Anxiety?

Social anxiety is a disorder characterized by a strong sense of fear or worry in social situations. It manifests in several ways, including:

• Fear of being judged or embarrassed during public speaking, when meeting new people, or when performing in front of others
• An overwhelming sense of unease in casual social situations, such as parties or gatherings, or even everyday circumstances like eating in public
• Physical symptoms, such as rapid heartbeat, blushing, sweating, or trembling during social interactions

The causes of social anxiety are complex and can vary among individuals, but they generally fall into two categories:

1. Biological factors
2. Environmental factors

Biological Factors

Biological factors are the physical or physiological conditions that can contribute to the development of social anxiety. They include:

• Genetics—Various studies suggest that individuals with a first-degree relative (parent or sibling) with social anxiety disorder have a higher risk of developing this problem
• Brain structure—The amygdala, a part of the brain that regulates fear responses, can be hyperactive in people with social anxiety, exacerbating fear responses
• Neurotransmitters—Imbalances in serotonin, a neurotransmitter that helps regulate mood, can contribute to depression and social anxiety

Environmental Factors

Environmental factors are the external influences that can contribute to social anxiety, including:

• Negative social experiences—Past experiences like bullying, rejection, or humiliation can contribute to the development of social phobia
• Family environment—Children who grow up with overprotective or controlling parents are more likely to develop social anxiety
• Cultural factors—Societal norms and expectations, such as a culture emphasizing humility and avoidance of public embarrassment, can contribute to social phobia

Learning the specific factors contributing to social anxiety can help you identify ways to cope with this condition. Inform your doctor about past experiences that may have resulted in you developing social phobia so they can prescribe the most effective medications for you.

Source: Kindel Media

How Do Social Anxiety Medications Work?

Social anxiety medications’ mechanisms of action depend on their active ingredients and the specific hormones or neurotransmitters they affect. These drugs typically fall into three groups:

1. Anti-anxiety medications (benzodiazepines)
2. Antidepressants
3. Beta-blockers

Anti-Anxiety Medications

Anti-anxiety medications from the benzodiazepines group enhance the effect of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. This neurotransmitter inhibits brain activity, reducing feelings of anxiety and fear. 

The main downside of benzodiazepines is that they can be habit-forming, so doctors typically prescribe them for short-term relief of acute symptoms.

The table below lists some benzodiazepines and their typical doses for anxiety disorders:

Anti-Anxiety Medication	Typical Daily Dose for Anxiety in Adults
Alprazolam	0.25 mg–0.5 mg, 3 times per day
Diazepam	2 mg–10 mg, 2–3 times per day

Antidepressants

There are various types of antidepressants, but selective serotonin reuptake inhibitors (SSRIs)  and serotonin and norepinephrine reuptake inhibitors (SNRIs) are commonly prescribed to patients with social anxiety. Here’s how they work:

• SSRIs—SSRIs increase serotonin levels in the brain by blocking its reabsorption (reuptake) into neurons. The hormone regulates mood, alleviating feelings of anxiety
• SNRIs—SNRIs increase the levels of serotonin and norepinephrine in the brain, making you feel calm and focused and reducing the symptoms of anxiety

The table below lists common SSRIs and SNRIs and their typical doses for anxiety disorders:

Medication	Type	Typical Daily Dose for Anxiety in Adults
Fluoxetine	SSRI	Varies depending on the patient’s health status
Sertraline	SSRI	Initially 25 mg once per day, typically increased to 50 mg once per day after one week
Venlafaxine	SNRI	75 mg once per day
Duloxetine	SNRI	60 mg once per day but can be increased to a maximum of 120 mg per day

Beta-Blockers

Beta-blockers are FDA-approved for treating heart conditions like angina, irregular heartbeat, and heart failure, but they can also reduce the effects of adrenaline, the hormone your body releases when you’re stressed or anxious. These drugs alleviate the physical symptoms of anxiety, such as:

• Trembling
• Sweating
• Rapid heartbeat

Since beta-blockers can alleviate the symptoms of anxiety, they can be used off-label to manage social phobia and performance anxiety—a type of social anxiety disorder occurring during specific activities or events, such as public speaking or performing on stage.

Check out the table below for more details on the beta-blockers typically prescribed to patients with occasional performance and social anxiety:

Beta-Blocker	Typical Dose for Anxiety in Adults
Propranolol	10–40 mg, taken two hours before the stressful situation—only taken when needed
Atenolol	50 mg, taken two hours before a performance—only used when necessary

Source: Huynh Van

Best Medications for Social Anxiety

Social phobia can stem from several factors, so the best treatment depends on your health status, the type of social anxiety problem, and whether it’s long-term or occasional. For instance, you may need strong benzodiazepines or antidepressants if you have chronic general or social anxiety, while beta-blockers may be a better pick if you feel anxious only in specific situations, such as during exams or interviews.

Learn about some of the best medications for social anxiety from the table below:

Drug	Category	Forms	Available Doses	Dosing Frequency and Treatment Horizon
Propranolol	Beta-blocker	Tablet Extended-release capsule	10 mg 20 mg 40 mg 60 mg 80 mg  120 mg 160 mg	As needed for performance anxiety
Atenolol	Beta-blocker	Tablet	25 mg 50 mg 100 mg	As needed for situational anxiety
Alprazolam	Benzodiazepine	Regular tablet Extended-release tablet Oral solution	0.25 mg 0.5 mg 1 mg 2 mg 3 mg	Typically 2–4 times a day for chronic anxiety for up to four months
Diazepam	Benzodiazepine	Tablet Oral solution	2 mg 5 mg 10 mg	Usually 2–3 times per day for chronic anxiety disorders for 2–4 weeks
Fluoxetine	SSRI	Capsule Tablet Oral solution	10 mg 20 mg 40 mg 60 mg	Typically once per day for several weeks or months
Sertraline	SSRI	Tablet Oral solution	20 mg 25 mg 50 mg 100 mg	Usually once per day for several months
Venlafaxine	SNRI	Tablet Extended-release capsule	25 mg 37.5 mg 50 mg 75 mg 100 mg	Typically once per day for up to one year
Duloxetine	SNRI	Capsule	20 mg 30 mg 40 mg 60 mg	Usually once per day for 6–12 months
Buspirone	Azapirone	Tablet	5 mg 7.5 mg 10 mg 15 mg 30 mg	Typically 2–3 times a day for general anxiety disorder
Hydroxyzine	Antihistamine	Tablet Oral solution Injection	10 mg 25 mg  50 mg	As needed for acute anxiety and insomnia

Each medication has benefits and risks, so you should discuss these factors and your medical history with your healthcare provider. They can determine which medication is safe and effective depending on your needs.

Source: fauxels

How To Get Social Anxiety Medication Prescribed

Most social anxiety medications are available only with a doctor’s prescription. These drugs are potent and can alter the levels of certain transmitters, affecting how we think and feel. They also interact with specific substances and aren’t suitable for everyone, so your doctor must assess your health status before prescribing them. Even if you need these drugs for occasional problems like performance anxiety, you should consult your healthcare provider first. 

One of the issues is that performance anxiety medications are stigmatized, and individuals who need them sometimes shy away from telling their doctors the specific reasons they need the drugs. The fantastic news is that with telemedicine platforms like Kick, you can consult healthcare professionals discreetly and get performance anxiety medications delivered to your doorstep in a few days.

Source: Henri Mathieu-Saint-Laurent

Kick—Instant Relief for Performance Anxiety

Kick uses a new approach to managing performance anxiety—less intimidating, more manageable, and centered around you. The platform offers the convenience of online consultations and spares you of unpleasantries that may contribute to social anxiety.

Once you join Kick, our doctor will review your information, prescribe propranolol or atenolol, and instruct you on how to use them. Your medicine will be delivered to your home or local pharmacy in discreet packaging, respecting your privacy.

If you need help while using the medications, you can consult your doctor via Kick’s online platform, ensuring you get the support you need almost instantly.

How To Join Kick

To get started with Kick, follow these steps:

1. Go to the signup page to start your 10-minute consultation
2. Fill out the questionnaire with your medical history and specific performance anxiety issues to help us design the best treatment for you
3. Add your delivery and payment details

Our team will assess your case and reach out within a day. If Kick isn’t the best solution for your specific issue, you won’t pay for the initial consultation, according to our Doctor Guarantee.

Kick’s program has earned glowing reviews on Trustpilot, demonstrating our commitment to providing a safe, effective, and convenient solution for individuals with situational anxiety.

Common Side Effects of Social Anxiety Medication

Social anxiety medications carry the risk of unwanted reactions, but patients who adhere to their doctor’s instructions rarely experience them. Check out the common side effects of these drugs in the table below:

Category	Common Side Effects
Beta-blockers	Fatigue Cold hands or feet Stomach upset Slow heartbeat Sleep disturbances
Selective serotonin reuptake inhibitors (SSRIs)	Nausea Nervousness Agitation or restlessness Dizziness Low sex drive
Serotonin and norepinephrine reuptake inhibitors (SNRIs)	Nausea Dry mouth Dizziness Constipation
Benzodiazepines	Drowsiness Dizziness Stomach upset Blurred vision Confusion

Most of these side effects should subside as the body adjusts to the medication and can be managed easily. Here are some of the ways to alleviate them:

• Stay hydrated—Dry mouth can be managed by drinking plenty of water throughout the day
• Eat small meals frequently —Nausea can be reduced by eating small, frequent meals instead of large ones
• Exercise regularly—Physical activity can help alleviate side effects like fatigue and constipation
• Limit caffeine—Reducing caffeine intake can help reduce agitation, nervousness, and sleep disturbances
• Follow the prescribed dosage—Always take the medication as instructed by your doctor
• Report severe side effects—If you experience severe or persistent discomfort while on these medications, contact your healthcare provider immediately

Social Anxiety Medications—Potential Interactions With Other Drugs

Social anxiety medications can interact with other drugs, altering their effectiveness or raising the risk of side effects. Learn about their potential interactions with different medicines in the table below:

Medication Category	Interaction With Benzodiazepines	Interaction With SSRIs	Interaction With SNRIs	Interaction With Beta-Blockers
Anti-HIV drugs	Some benzodiazepines can raise the risk of breathing problems	Anti-HIV drugs can increase the risk of serotonin syndrome	Anti-HIV medications can enhance the risk of serotonin syndrome	Can raise the risk of heart complications
Anti-seizure medication	Some benzodiazepines can raise the levels of anti-seizure medication in the blood	SSRIs can raise the potency of anti-seizure medication	SNRIs can alter the potency of anti-seizure medication	Beta-blockers may enhance the potency of anti-seizure medication
Antihistamines	Can contribute to side effects like dizziness and drowsiness	Can raise the risk of drowsiness, dry mouth, and blurred vision	Can contribute to drowsiness and dizziness	Can contribute to low blood pressure, dizziness, and lightheadedness
Blood pressure medication	Benzodiazepines can contribute to low blood pressure	Can raise the risk of low blood pressure	SNRIs can enhance the risk of high blood pressure	Can enhance the risk of low blood pressure
Heart medications	Benzodiazepines can contribute to heart complications	SSRIs can raise the risk of abnormal heart rhythm	SNRIs can contribute to low blood pressure and irregular heart rhythm	Beta-blockers can contribute to irregular heartbeat and low blood pressure
Infection medications	Can alter the potency of either medications	SSRIs may reduce the efficacy of antibiotics in some cases	SNRIs can enhance bacteria’s resistance to infection medications	Beta-blockers may react with some antibiotics, raising the risk of unwanted reactions
Muscle relaxants	Can contribute to drowsiness or respiratory issues	Can raise the risk of serotonin syndrome	Can contribute to serotonin syndrome	Can contribute to side effects like dizziness, drowsiness, or changes in heart rate
Opioids and CNS depressants	Can raise the risk of sedation	SSRIs can enhance CNS depressant effects	SNRIs can increase the risk of sedation	Beta-blockers can add to CNS depressant effects
Sleep medications	Can contribute to dizziness and drowsiness	SSRIs can contribute to the sedative effects	SNRIs can add to sedation	Beta-blockers can reduce the effectiveness of sleep medications
Non-steroidal anti-inflammatory drugs (NSAIDs)	Can enhance the analgesic effect of NSAIDs	Can increase the risk of unwanted reactions, such as gastrointestinal bleeding	Can raise the risk of side effects	Non-selective NSAIDs can raise the risk of high blood pressure
Blood thinners	The potential for interaction is low, but risks can’t be ruled out	Some SSRIs can slow down the metabolism of blood thinners, contributing to an overdose of anticoagulants	Some SNRIs can raise the risk of gastrointestinal bleeding	Beta-blockers can inhibit the metabolism of blood thinners, increasing the risk of bleeding
Medications that increase serotonin levels	Can contribute to drowsiness	Can raise the risk of serotonin syndrome	Can enhance the risk of serotonin syndrome	The potential for interaction is low, but risks can’t be disregarded
CYP3A4 inhibitors and inducers	Minor interaction reported	Can reduce SSRI efficacy	Can affect SNRI levels in the blood	Can alter the effectiveness of beta-blockers

This list isn’t exhaustive—you should inform your doctor about the drugs or substances you use before getting social anxiety medications prescribed. Your healthcare provider will assess the potential interactions and prescribe the appropriate doses to reduce the risk of undesired reactions.

Source: Luis Quintero

Alternatives to Social Anxiety Medications

If your doctor decides that medication isn’t the best option for you due to potential interactions, they may recommend non-pharmaceutical alternatives, such as:

• Cognitive behavioral therapy (CBT)—It can help you identify and change thought patterns that exacerbate anxiety, reducing the risk of a panic attack
• Relaxation techniques—They include meditation, controlled breathing, and visualization to help you calm nerves in stressful situations
• Support groups—You can share experiences with others who are going through the same struggles to learn the strategies or tricks they use to cope with the condition

These alternatives can also be combined with medication, helping you reach a lasting solution to social phobia.

Featured image source: Kindel Media