Social Phobia Tretament: Using Medications

I'm in the position where I believe social phobia should not be considered a “disorder”. The fact that you call it that way gives me the idea of illness. I would say it should be viewed as a condition, where the person needs to develop social skills through an integral treatment: healthy lifestyle, therapy (CBT), medicines, some type of spiritual discipline.

The idea with this post is to express my own experience with social anxiety treatment and medication, it is not intended to supplement, not substitute for, the expertise and judgment of your physician, neither to diagnose a health condition, but it can be used as a source to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed. A consultation with a medical professional, such as a psychiatrist who specializes in anxiety, is an important and necessary step when medication is being considered for social anxiety.

In the first place, not everyone with social phobia needs to be on medication. There are many factors that need to be taken in account, such as severity of the condition, conferring with your anxiety specialist, your psychiatrist, other medications you take and your general medical condition, etc. and the way you know your body responds to medication in general.

Please keep in mind that while medication can be very helpful in some cases, it is NOT a cure. It will not get you to where you want to be, it will not be the "solution".

I see medication as a "tool" or as an "encouragement" while undergoing a therapy process (e.g. cognitive-behavioral therapy). But it is the therapeutical process that helps you change your brain pathways (neural pathways) permanently, NOT the medication. Medication generally works faster (if it works), but permanent results (physiological changes) can only occur by learning to think and beginning to feel differently.

If you are looking for a band-aid, get the medication and ignore the therapeutical process.

If you are looking for a permanent solution (a change in your brain's chemistry and neural pathways), start a therapeutical process (CBT is mentioned as one of the most effective therapies) , along with a gradual change in your lifestyle and the practice of some type of spiritual discipline (religion, meditation, etc). The idea with CBT is to practice changes on the way you think and adapt, to improve your behavior on social situations, until it becomes an automatic habit. Medication changes brain chemistry temporarily; a therapy process can help you develop social skills to improve your quality life.

I’m on CBT (Cognitive Behavioral Therapy) process, started a couple months ago, I have taken medication before (Paxil), right now I’m not, but I will if it’s recommended by a psychiatrist with knowledge and expertise in social anxiety management and treatment.

I have found a general information guide about social anxiety medicines at: phobia-fear-release.com. It does not appear to me a based scientifically researched guide (they don’t show any reference to studies to support these findings); however I thought you could use it as an information resource to get a general overview of the classification and different medicines used to treat anxiety so you can have a reference to consult your physician when considering the use of medicines to treat social anxiety:

1- SSRIs - Social Anxiety Medication
Prozac, Zoloft, Paxil
Some research shows a 15-45% success rate in temporarily reducing social anxiety symptoms. Research also shows over 60% of people who have been prescribed an SSRI have had fairly negative responses.

2 - Anti anxiety agents - Social Anxiety Medication
Ativan and Klonopin
These are the agents of choice for starting anxiety management. The most positive research is available on these two anti-anxiety agents.”

These medications can be very helpful for people with social anxiety. These social anxiety medications are tolerated well and almost always help.

Sides effects are: tiredness at first. There seems to be more research support for the use of Ativan (lorazepam) and Klonopin (clonazepam) in the treatment of social anxiety than the other anti-anxiety medications.

When stopping anti-anxiety use, it is necessary to taper off the medication slowly, by reducing the dose gradually over a period of 3 to 4 weeks.

3 - MAOIs - Social Anxiety Medication
Parnate, Nardil
These medications, in general, have been shown to work effectively approximately 60-85% of the time for people with clinical social anxiety. Many people with social anxiety do not need this medication, however. If a medication is needed in addition to the anti-anxiety agents, these medications have been shown to work best for social anxiety disorder.

Research does show, Parnate as opposed to Nardil, is more effective with (generalized) social anxiety disorder, provided there are no other anxiety or mental health care complications. (Nardil has been shown by research to be effective, also. These medications require slight food restrictions.

4 - RIMAs - Social Anxiety Medication
RIMAs or the reversible MAOIs are available almost everywhere else in the world except the United States. It is possible to have your psychiatrist write a prescription for a RIMA and have it filled at a pharmacy in Australia, New Zealand, or in Europe. It will then be mailed to you. In general, moclobemide appears to be much less effective for social anxiety than Parnat or Nardil.

5- Tri-cyclic antidepressants (TCAs) - Social Anxiety Medication
BuspironeGenerally are TCAsnot much help for social anxiety. Buspirone may provide limited help, however empirical research is lacking. Research shows very little success from this medication when it is prescribed for social anxiety.

Other resources to Social Anxiety Treatment:
General Guide on Social Anxiety - Wikipedia
Social Anxiety Treatment - Yahoo Health
Social Phobia Medicines - About.com

Note: This information is intended as a general guide only. It is essential you consult with your psychiatrist about any medication, due to individual and/or interaction effects, and additional medical complications. It is also essential that you work with a psychiatrist that FULLY understands social anxiety and has kept up with the latest research on medical treatment for social anxiety.