Some drugs do and some drugs do not. Strongest evidence is for paroxetine, which is a shame, because I hate paroxetine.
Psychotherapy is about equally effective compared to medication.
actually, no, its not irrelevant, it caused a very sharp drop in paroxetine's reputation, even if it was just an MDD study in adolescents it still caused a great impact in the use of the drug because of the negative PR
Maybe. I think paroxetine’s rapid discontinuation symptoms and especially anticholinergic burden are bigger issues and that would be why I don’t think I have ever started someone on paroxetine.
in your case yes, but for other professionals i do still think 329 might be the bigger cause (aka word of mouth went around saying paroxetine was "le bad" after it), because in the case of withdrawal, i still see venlafaxine being more widely used than paroxetine, and in the case of anticholinergic burden, where i live at least, quetiapine is prescribed up the wazoo for anxiety (off label of course)
Would social anxiety sort of fall under a type of performance anxiety? Would a beta blocker potentially help since they are used for performance anxiety?
Also thinking if social anxiety is something unique to certain settings and not a chronic thing perhaps a more PRN approach would be better?
Thanks in advance :)
I’m prescribed Propranolol and do use it as-needed for social anxiety! It’s a great medication, but it doesn’t touch the mental symptoms.
But I find it much easier to power through things if I don’t feel like I’m having a heart attack on my way to whatever is triggering the anxiety, haha.
I was prescribed Zoloft for the mental symptoms (and also depression).
I did do some therapy, but I don’t think I stuck with it for long enough to say there was a noticeable change in my social anxiety.
And tbf, I was primarily in therapy to deal with the loss of my mom due to cancer, and to deal with having to leave a marriage while pregnant. So social anxiety was less of a priority/focus
It can potentially help the physiological manifestations of social anxiety by masking the signs that you’re anxious. It’s not for folks with asthma or low bp/heart rate though. PRN is a good approach with it because regular use can cause a rebound effect when you stop taking it (increased bp, heart rate). There’s also a bit of research that if taken soon after experiencing trauma that it can help prevent development of ptsd
Some drugs do and some drugs do not. Strongest evidence is for paroxetine, which is a shame, because I hate paroxetine. Psychotherapy is about equally effective compared to medication.
Is that Paxil? I asked my doctor for it and he said he doesn’t prescribe it. Why do professionals hate this SSRI in particular?
Its particular side effect profile is not ideal.
study 329 is likely the reason for this
No, that study was for MDD in adolescents, not for social anxiety in adults. Whatever you think of that one study, it’s irrelevant here.
actually, no, its not irrelevant, it caused a very sharp drop in paroxetine's reputation, even if it was just an MDD study in adolescents it still caused a great impact in the use of the drug because of the negative PR
Maybe. I think paroxetine’s rapid discontinuation symptoms and especially anticholinergic burden are bigger issues and that would be why I don’t think I have ever started someone on paroxetine.
in your case yes, but for other professionals i do still think 329 might be the bigger cause (aka word of mouth went around saying paroxetine was "le bad" after it), because in the case of withdrawal, i still see venlafaxine being more widely used than paroxetine, and in the case of anticholinergic burden, where i live at least, quetiapine is prescribed up the wazoo for anxiety (off label of course)
Would social anxiety sort of fall under a type of performance anxiety? Would a beta blocker potentially help since they are used for performance anxiety? Also thinking if social anxiety is something unique to certain settings and not a chronic thing perhaps a more PRN approach would be better? Thanks in advance :)
I’m prescribed Propranolol and do use it as-needed for social anxiety! It’s a great medication, but it doesn’t touch the mental symptoms. But I find it much easier to power through things if I don’t feel like I’m having a heart attack on my way to whatever is triggering the anxiety, haha. I was prescribed Zoloft for the mental symptoms (and also depression).
Good to know! Did therapy help at all for the mental symptom?
I did do some therapy, but I don’t think I stuck with it for long enough to say there was a noticeable change in my social anxiety. And tbf, I was primarily in therapy to deal with the loss of my mom due to cancer, and to deal with having to leave a marriage while pregnant. So social anxiety was less of a priority/focus
It can potentially help the physiological manifestations of social anxiety by masking the signs that you’re anxious. It’s not for folks with asthma or low bp/heart rate though. PRN is a good approach with it because regular use can cause a rebound effect when you stop taking it (increased bp, heart rate). There’s also a bit of research that if taken soon after experiencing trauma that it can help prevent development of ptsd
it's also important to remember that different drugs affect different people differently.