The Shyness & Social Anxiety Workbook
102These drugs may affect a person’s ability to drive safely and they tend to interact 
strongly with alcohol. In addition, they should be used with caution by older people 
because higher dosages have been associated with a greater likelihood of falling.
There are several advantages to taking benzodiazepines compared with antidepres -
sant medications. First, they work very quickly (within a half hour) and therefore can 
be used on an “as needed” basis to deal with particularly stressful situations. They also 
may be used during the ﬁrst few weeks of antidepressant treatment, while the indi -
vidual waits for the antidepressant to take effect. In addition, the side effect proﬁle of 
 benzodiazepines is quite different from that of antidepressants, and these drugs may be 
more easily tolerated by some people.
Despite these beneﬁts, benzodiazepines have fallen out of favor in recent years, 
mostly because they can be difﬁcult to discontinue. Stopping these drugs can cause 
temporary (but sometimes intense) feelings of anxiety, arousal, and insomnia. In rare 
cases, abrupt discontinuation can cause seizures. Given that discontinuation from these 
medications can cause intense anxiety, it is not surprising that some individuals have 
difﬁculty stopping these drugs. The symptoms of withdrawal can be minimized by dis -
continuing these drugs very gradually. Benzodiazepines are a potentially effective option 
for treating social anxiety, particularly over brief periods. However, they are typically 
not recommended as a ﬁrst-line treatment (Swinson et al. 2006).
TREATMENT WITH BETA-ADRENERGIC BLOCKERS