Selective serotonin reuptake inhibitors for social anxiety disorder

Search Knowledgebase

Topic Contents

Selective serotonin reuptake inhibitors for social anxiety disorder


Generic NameBrand Name
escitalopram oxalateCipralex
fluoxetine hydrochlorideProzac
fluvoxamine maleateLuvox
paroxetine hydrochloridePaxil
sertraline hydrochlorideZoloft

How It Works

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

Why It Is Used

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

How Well It Works

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

Side Effects

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.

Advisories. Health Canada and the U.S. Food and Drug Administration (FDA) have issued:

  • Advisories on antidepressant medicines and the risk of suicide. Health Canada and the FDA do 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.
  • Warnings 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.
  • Warnings 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

SSRIs usually are started at low doses and increased gradually. You may start to feel better in 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 medicine or combine it with another medicine 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 medicines can cause negative side effects or a relapse of anxiety symptoms.

Taking medicines for social anxiety disorder during pregnancy may increase the risk of birth defects. If you are pregnant or thinking of becoming pregnant, talk to your doctor. You may need to take medicine if your social anxiety disorder is severe. Your doctor can help you weigh the risks of treatment against the risk of harm to your pregnancy.

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.

SSRIs make bleeding more likely in the upper gastrointestinal tract (stomach and esophagus). Taking SSRIs with NSAIDs (such as Aleve or Advil) makes bleeding even more likely. Taking medicines that control acid in the stomach may help.1

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.



  1. Abajo FJ, Garcia-Rodriguez LA (2008). Risk of upper gastrointestinal tract bleeding associated with selective serotonin reuptake inhibitors and venlafaxine therapy. Archives of General Psychiatry. 65(7): 795–803.


By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Specialist Medical Reviewer Andrew Swan, MD, CCFP, FCFP - Family Medicine
Last Revised December 8, 2009

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.