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Doctors' Answers to "Frequently Asked Questions" - Social Anxiety

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An indi vidual patient is always advised to consult their own physician.

[posted 04/10/2000]
Question: I am quite sure I have social anxiety disorder and would like some form of treatment. I have heard of the possibility of Xanax or Paxil but I am currently taking Prevacid for acid reflux. Would these be safe if taken at the same time?

Answer: Shouldn't be a problem. Most would start with Paxil due to less side effects and no addictive potential.

[posted 03/19/2000]
Question: I saw an advertisment in a magazine while sitting in my gyn office there for an appointment about 6 months ago. I have problems with being social, especially with being afraid of embarrasing myself or what people will think about what I say or do. Alot of times I just avoid socializing. Im so afraid, when I do try to socialize, my mind goes blank and dont know what to say. I asked my gyn to prescribe this for me while I was there after taking the self test on the article. She did and I tried it for about two weeks. I felt as if I was in a tunnel and did not feel myself, I felt as if I couldnt consintrate(I work full time and also go to college full time, so I have to be able to consintrate). I got eritable and did not want any type of sexual activity at all. I felt this was causing more problems than I had before taking it. Do you think maybe this 20mg was too strong,(I weigh 120lbs at 5'5). Latley I have noticed my social disorder is really a problem. I really dont want to do things with my friends and family or social events. I feel so much that I say the wrong things or my mind goes blank and dont even know what to say(even with my father on the phone), and will avoid social contact. I dont have any problem with my boyfriend (we live together), what's the difference?
A friend of mine takes Zoloft, she says I should try it. But before I give up on Paxil I would like to try the correct dosage. Any suggestions?
I tried taking 1/2 of the 20mg paxil today. I feel fine but I havent had any social contact with anyone but my boyfriend today.
Also, actually what is a panic attack, or social anxiety?
I think of a panic attack as throwing a screeming, kicking fit.

Answer: Any of the SRI drugs can treat this problem. Paxil is advertising since they have researched it, but we commonly use any of the class to treat the problem. I would expect zoloft and paxil to have similar side effects. But, there are other option like Celexa, Wellbutrin and Effexor. First, cut to 10 mg and see if it helps without the side effects. If this doesn't help, work your way through the above medications and see what works without depressed sexual drive.

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