evidence that either of these medications works any better or worse than most other 
SSRIs for this problem. In practice, any of the SSRIs can be used to treat problems with 
social anxiety. Other SSRIs that have been found to be effective for social anxiety disor -
der include ﬂuvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro in the 
United States, Cipralex in Canada). Fluoxetine (Prozac) has been found to be effective 
in some studies, but not others (Hedges et al. 2007; Swinson et al. 2006).
Although the side effects vary slightly across the SSRIs, some of the most common 
ones include nausea, diarrhea, headache, sweating, increased anxiety, tremor, sexual dys -
function, weight gain, dry mouth, palpitations, chest pain, dizziness, twitching, constipa -
tion, increased appetite, fatigue, thirst, and insomnia. Don’t be discouraged by the long 
list of side effects. Most people experience only a very small number of these, and some 
individuals experience no side effects at all. Side effects are generally quite manageable. 
They tend to be worse during the ﬁrst few weeks of treatment and can be managed by 
keeping the dosage low until the person becomes used to the medication. Certain side 
effects (for example, medication-related weight gain and sexual dysfunction) tend not to 
decrease over time, unless the drug is stopped or the dosage is decreased.
SSRIs typically take two to four weeks before they start working. They are believed 
to work by altering serotonin levels in the brain. Serotonin is an example of a neurotransmitter , 
which is a chemical involved in the transmission of information from one brain cell to the