What pharmacological treatments are considered first-line for managing Social Anxiety Disorder?

For adults with Social Anxiety Disorder who decline cognitive behavioural interventions and express a preference for medication, the first-line pharmacological treatment is a selective serotonin reuptake inhibitor (SSRI) ¹. Specifically, escitalopram or sertraline should be offered ¹. Before prescribing any pharmacological intervention, it is important to discuss treatment options and any concerns the person has about taking medication ¹. This discussion should include the likely benefits, potential side effects, discontinuation syndromes, drug interactions, and the risk of early activation symptoms with SSRIs (such as increased anxiety or agitation) ¹. Patients should also be informed that the full anxiolytic effect develops gradually over two weeks or more, and that treatment should continue after remission to prevent relapse ¹.