What are the main medicines for social anxiety?
If you are prescribed a medicine, then there may be many reasons why that one has been chosen. These might include:
- side effects (which ones are important to you)
- local policies or agreements (such as what your GP surgery uses or agreements in your area)
- national policies (e.g. NICE, SIGN - see last question)
- familiarity (it may be better for prescribers to use medicines they are familiar with)
- relative costs for similar medicines (if two medicines are very similar, why waste money on the more expensive one?)
- personal preference (either yours or your prescriber)
- how bad your symptoms are
- any medicine you might have done well with in the past (as it's more likely to work again)
The main medicine treatment options are listed below. They are divided into "Main medicines" and "Others".
For convenience, the "Main medicines” are those medicines that are officially "approved" to treat the condition or symptoms (www.bnf.org/bnf/) and which are listed in the British National Formulary (BNF). To be listed in the BNF there needs to be good evidence that the medicine works and that the manufacturers have applied for a license (a long and costly exercise). "Others" are those medicines where there is some evidence that they help, but either not enough for a license or that no license has been applied for. These should usually only be used where other standard treatments have failed.
- SSRIs (other ones such as sertraline, fluoxetine, citalopram)
- Benzodiazepines (such as diazepam and clonazepam) to help treat the anxiety directly
- Beta-blockers (such as propranolol) - to help reduce the increased heart rate and shaking or tremor that can occur in social anxiety and performance anxiety, although there is little evidence this works
- Other serotonin or noradrenaline boosters (such as venlafaxine, mirtazapine, moclobemide)