Selective serotonin reuptake inhibitors for social anxiety disorder

Examples

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Brand Name	Generic Name
Celexa	citalopram

Brand Name	Generic Name
Lexapro	escitalopram oxalate

Brand Name	Generic Name
Prozac	fluoxetine hydrochloride

Brand Name	Generic Name
Luvox	fluvoxamine maleate

Brand Name	Generic Name
Paxil	paroxetine hydrochloride

Brand Name	Generic Name
Zoloft	sertraline hydrochloride

How It Works

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Selective serotonin reuptake inhibitors (SSRIs) affect brain chemicals (neurotransmitters) and reduce anxiety and depression.

Why It Is Used

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SSRIs are used to reduce anxiety and depression associated with social anxiety disorder.

How Well It Works

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SSRIs reduce the severity of anxiety related to anticipating a panic attack when facing a feared event in social anxiety disorder.

Side Effects

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Side effects of SSRIs include:

• Dry mouth.
• Headache.
• Weight gain.
• Nausea, loss of appetite, or diarrhea.
• Feeling irritable or anxious.
• Problems sleeping.
• Drowsiness.
• Loss of sexual desire or ability.
• Tremor or shaky hands.

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:

• An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.
• A warning about the antidepressants Paxil and Paxil CR and birth defects. Taking these medicines in the first 12 weeks of pregnancy may increase your chance of having a baby with a birth defect.
• A warning about taking triptans, used for headaches, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a very rare but serious condition called serotonin syndrome.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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SSRIs usually are started at low doses and increased gradually. You may start to feel better within 1 to 3 weeks of taking an SSRI. But it can take as long as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor. If you experience side effects that won't go away (such as sexual dysfunction), your doctor may change your medication or combine it with another medication to help reduce such side effects.

Never suddenly stop taking antidepressants. The use of any antidepressant should be tapered off slowly and only under the supervision of a doctor. Abruptly stopping antidepressant medications can cause negative side effects or a relapse of anxiety symptoms.

People with liver disease usually require lower doses of SSRIs.

Studies have found daily use of SSRIs may increase the risk of bone fracture in adults over age 50. Talk to your doctor about this risk before taking an SSRI.

For more information on selective serotonin reuptake inhibitors, see Drug Reference. (Drug Reference is not available in all systems.)

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Credits

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Author	Jeannette Curtis
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Denele Ivins
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Lisa S. Weinstock, MD - Psychiatry
Last Updated	August 27, 2007