Medications for Social Anxiety and Social Anxiety Disorder
99next. Serotonin is thought to be involved in the regulation of emotion and other aspects 
of psychological functioning.
Most SSRIs are relatively easy to discontinue, although paroxetine is more likely 
than the others to cause withdrawal symptoms during discontinuation because it is 
metabolized more quickly by the body. Therefore, paroxetine should be stopped more 
gradually than the other SSRIs. Common withdrawal symptoms during discontinuation 
of paroxetine include sleep disturbances, agitation, tremor, anxiety, nausea, diarrhea, dry 
mouth, vomiting, sexual disturbances, and sweating.
Selective Serotonin and Norepinephrine Reuptake 
Inhibitors (SNRIs)
Venlafaxine XR (Effexor XR) is currently the only available SNRI that has been 
found in large studies to be effective for treating social anxiety disorder—in fact, it is 
approved by the FDA for this purpose (the “XR” stands for “extended release”). Unlike 
the SSRIs, venlafaxine acts both on the serotonin and norepinephrine neurotransmitter 
systems, both of which appear to be related to problems with anxiety and depression. 
A number of well-controlled studies suggest that venlafaxine is useful for treating social 
phobia (Swinson et al. 2006), although, like the SSRIs, it takes several weeks to have 
an effect. The most commonly reported side effects of venlafaxine include sweating, 
nausea, constipation, loss of appetite, vomiting, sleepiness, dry mouth, dizziness, ner -
vousness, increased anxiety, and sexual disturbances. When discontinued too quickly, 
the most common withdrawal symptoms include: sleep disturbances, dizziness, nervous -