Treating Specific Phobia With Drugs

Medication is more common in the treatment of social phobia and agoraphobia than for specific phobia.

• People with social phobia, or social anxiety disorder, feel intensely self-conscious and tend to avoid social interaction.
• Agoraphobics are afraid of places or situations that make them feel trapped, alone, and helpless.
• Specific phobia is a fear of a specific object or situation (for example, a fear of dogs or thunder).

All phobias are a form of anxiety disorder, so most medications address that issue.

Antidepressants (SSRIs) for Social Phobia

Selective serotonin reuptake inhibitors, or SSRIs, are a group of antidepressants effective for treating anxiety, social phobia, and agoraphobia. They work by changing the level of serotonin in the brain, believed to control your mood.

Examples of some of the SSRIs a physician may prescribe for social anxiety disorder include:

• Celexa (citalopram)
• Zoloft (sertraline)
• Prozac (fluoxetine)
• Paxil (paroxetine)

Possible side effects of SSRIs include:

• Headaches
• Nausea
• Sleep problems

MAOIs for Social Phobia

Physicians may prescribe monoamine oxidase inhibitors (MAOIs), often considered a second tier treatment for social phobia. They inhibit the enzyme monoamine oxidase, which breaks down certain neurotransmitters in the brain.

Commonly prescribed MAOIs include:

• Nardil (phenelzine)
• Manerix (moclobemide)
• Parnate (tranylcypromine)

Possible side effects of MAOIs include:

• Agitation
• Dizziness
• Stomach problems

Benzodiazepines for Social Phobia

Benzodiazepines are mild tranquilizers that can be effective against phobias by reducing the level of associated anxiety. Physicians prescribe this social phobia medication on a short-term basis at the lowest dosage possible.

Benzos are well-tolerated but present clinical issues such as dependence and a possible increased risk of dementia in older patients taking it for 3 to 6 months and an even greater risk for those taking it for more than 6 months, according to a data analysis of 2,000 men and women published in the journal BMJ.

Commonly prescribed benzodiazepines include:

• Valium (diazepam)
• Xanax (alprazolam)
• Klonopin (clonazepam)
• Ativan (lorazepam)

Side effects of low doses include:

• Impaired memory
• Depression
• Drowsiness
• Feeling hungover the next day

Beta-Blockers for Short-term Relief

Beta-blockers work by suppressing the effects of epinephrine, or adrenaline, in the body. They also block associated physical effects of high adrenaline, such as sweating and heart palpitations. A beta-blocker your physician may prescribe is Inderal (propranolol).

Some beta-blockers provide short-term phobia relief because they slow your heart rate and decrease your blood pressure. They might be useful if you suffer from social phobia but must give a speech.

Possible side effects of beta-blockers include:

• Cold fingers
• Sleep problems and feeling tired
• Stomach problems

Other Medications

Other medications that have been studied for the treatment of social phobia include:

• Antiepileptic drugs: gabapentin, Lyrica (pregabalin), Keppra (levetiracetam)
• Tricyclic antidepressants: Tofranil (imipramine) and Anafranil (clomipramine)

Discontinuing Phobia Medication

You must seek the advice of your physician if you want to decrease your dosage or stop taking your phobia medication. Drugs for social anxiety disorder can have unexpected emotional and physical side effects if you don't go off them gradually.

Phobia medications, like other medications, can be extremely costly. In addition, some people do not like the way certain drugs make them feel. The risks of discontinuation vary by the type of medications you are on, but it is never a good idea to simply stop taking any medications without consulting your doctor.

Side Effects and Warnings

To maintain your health and safety let your physician know of any other prescription or over-the-counter medications that you take, as well as any health supplements. If you have multiple doctors, keep each one up to date.

Be sure to read all medication inserts and always contact your doctor or pharmacist if you have any questions or concerns.