Took Paroxetine for social anxiety. Less side-effect drug?

Question

Hello doctor,

I was affected by a social anxiety disorder. For the last two years, I first used Inderal for one year and then Paroxetine (SSRI) 20 mg for the second year. When I used SSRI for one year, my problem fully recovered, and later on, by doctors advise, I left the tablets. Now, 25 days passed that I have not used SSRI tablets, and now the problem started again. My face and ears turn red when I try to talk to someone, and I have started to take Inderal 40 mg tablets in the morning. What should I do? Is there any tablet besides SSRI, which works best and has no harmful side effects. As SSRI has strong side effects, and I have noticed it during my discontinuation syndrome. Can you suggest me the tablets which work best as I have to give presentation after some days in my class. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

You are reporting a relapse of some social anxiety symptoms after discontinuation of Paroxetine SSRI (selective serotonin reuptake inhibitor) medication.

Depending on the extent of your social anxiety symptoms, you have two options:

1) If anxiety is predominantly situational (like giving a presentation in a class and other social interactions), then just taking Inderal (Propranolol) 40 mg once daily as needed should be helpful. Check with your doctor about not having any contra-indications before taking propranolol.

2) If anxiety is pervasive and not allowing you to function normally, you can try other SSRI like Sertraline. SSRIs are one of the safest medications to manage long term anxiety.

Did you have any CBT (cognitive behavioral therapy) for managing social anxiety? They are very effective. CBT will lessen the need for medication and will help to prevent relapse. Consult a psychologist in your city for CBT.

You can also try deep breathing techniques and progressive muscle relaxation exercise daily.