Best SSRI's for social anxiety/panic attacks

Originally Published: March 7, 2014
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Hi Alice,

I was wondering what types of SSRI's would work best for social anxiety and panic attacks so I can discuss with my general practitioner.? I know different ones work better than others for this problem, but I'm not sure. I don't find that my current medication helps much. Thanks so much!

Dear Reader,

First off, you aren’t alone—millions of people suffer from anxiety disorders, which can include panic attacks and social anxiety. Thankfully, there are a number of different treatments that have proven effective in treating these conditions. Before beginning any sort of new treatment, it's a good idea to talk with a mental health professional who can help you identify what you’re experiencing and determine what sort of treatment might work best for you (more on that later). First, here's some additional information that may prove helpful.

Generally, a panic attack is a sudden feeling of overwhelming fear that has no clear cause and immediately leads to intense physical reactions. There are a variety of symptoms associated with panic attacks—rapid heartbeat, shortness of breath, sweating, and trembling, to name a few. As far as treatments are concerned, psychotherapy, medicine, or a combination of the two is commonly recommended.

It’s difficult to say whether one medication will work better than another because every person reacts differently to medication. You referred to Selective Serotonin Reuptake Inhibitors (SSRIs), which are the most common class of medications used to treat anxiety disorders. SSRIs prevent the absorption of serotonin, a chemical in the brain that facilitates communication between the brain cells. Serotonin has also been shown to help boost a person’s mood, so an excess of serotonin can often lessen anxiety and depression. By inhibiting serotonin absorption, SSRIs help maintain this excess. There are many different types of SSRIs — a psychiatrist or other mental health professional can help you find the right fit if that's the route you choose.

Medication is just one type of treatment. If you’re seeing a general practitioner (GP), you may want to ask for a referral to a therapist who specializes in anxiety disorders. One treatment a therapist might suggest is Cognitive Behavioral Therapy (CBT). CBT is a type of psychotherapy that can help patients cope with fears in a way that can also help reduce anxiety. In CBT, a therapist helps patients re-imagine a fearful situation and the physical symptoms that are associated with it. The idea is that by practicing this mental exercise, you will become more comfortable with your fears. So that eventually, if you do experience a panic attack, you will be able to quickly alleviate your own symptoms. If you're a Columbia student you can contact Counseling and Psychological Services (Morningside) or the Mental Health Service (CUMC) to make an appointment to see a therapist and get more information on what treatment options might be best for you.

Whatever treatment you and your health care provider decide on, remember that overcoming anxiety is a process, but it’s achievable. Just keep breathing!

Alice