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Does Lexapro help with social anxiety?

Does Lexapro help with social anxiety?

Reviewed by:
Brenda Camacho, MD
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June 22, 2024
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If you have social anxiety disorder, or social phobia, everyday social situations can cause you to experience extreme anxiety. Physical symptoms—like blushing, shortness of breath, and fast heart rate –and emotional symptoms—like intense worry, self-consciousness, and fear of embarrassment—can lead you to avoid any potentially triggering scenarios.

Many people with social anxiety disorder find relief from psychiatric medications. These can reduce symptoms, helping you feel more confident in any given social interaction and improving your overall quality of life. One medication people might take for social anxiety is Lexapro, the brand name for escitalopram.

Curious about Lexapro or wondering what the best medication for social anxiety is? Read on to learn about Lexapro’s FDA-approved indications, other social anxiety medications, side effects, and more.  


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Can you take Lexapro for social anxiety disorder?

Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI). Although it is not FDA-approved for social anxiety disorder, some doctors may prescribe it “off-label.” Off-label means that although the FDA hasn’t approved this medication for the specific condition, some studies have shown it can be effective for this use.  

For example, research has found that Lexapro is beneficial for treating social anxiety while also being well tolerated, meaning it has minimal side effects. One study even compared the efficacy of Lexapro to Paxil, a medication that is FDA-approved for social anxiety, and found that Lexapro actually outperformed Paxil.

Technically, Lexapro is only FDA-approved for the treatment of generalized anxiety disorder (GAD) and major depressive disorder (MDD).

If your doctor prescribes you Lexapro off-label, they will advise you on specific dosages. In general, the starting dose is typically 5mg or 10 mg daily daily.

Lexapro doesn’t work right away. It can take several weeks, even up to 8 weeks of treatment, to notice a major difference in your symptoms, but often people notice small improvements after two weeks.  

Antidepressants approved for social anxiety

There isn’t a one-size-fits-all best medication for social anxiety, but there are three medications that have been FDA-approved for the treatment of social anxiety disorder, including:

  • Paxil (paroxetine)
  • Zoloft (sertraline)
  • Effexor (venlafaxine)  
    Paxil and Zoloft are selective serotonin reuptake inhibitors (SSRIs) similar to Lexapro, and Effexor is a serotonin-norepinephrine reuptake inhibitor (SNRI). These medications are typically the first-line choices for social anxiety disorder.  

Other medications that can help with social anxiety

Many other medications are used to help treat social anxiety. However, these medications are used off-label and are not FDA-approved specifically for social anxiety.  

Examples of other medications for social anxiety are:

  • Other SSRIs: Prozac (fluoxetine) and Celexa (citalopram) are other SSRIs that may benefit social anxiety.  
  • Gabapentin: Gabapentin is a medication meant for treating nerve pain and seizures, but doctors may use it off-label for various anxiety disorders, including social anxiety.
  • Beta-blockers: Beta-blockers such as propranolol are used for social anxiety. Although these medications are technically for cardiovascular conditions, they can help reduce physical anxiety symptoms such as a racing heart, shaking, and sweating. Typically, these are taken as needed before triggering social situations.  
  • Benzodiazepines: If your social anxiety is severe and causes you intense panic attacks, your doctor might consider benzodiazepines, AKA benzos like Xanax (alprazolam). However, these are controlled substances with a high risk for abuse and addiction, so they are typically only prescribed short-term if at all.

What are common side effects of medications used to treat social anxiety?

Any medication comes along with the risk of side effects. Here are some potential side effects that may occur with medications such as Lexapro or other SSRIs:

  • Drowsiness
  • Increased anxiety
  • Nausea
  • Vomiting
  • Dizziness
  • Headache
  • Dry mouth
  • Trouble sleeping
  • Sexual dysfunction  
  • Changes to appetite (loss of appetite or increased appetite)
  • Blurred vision  

These side effects are typically mild and typically subside after a few weeks of taking and adjusting to the medication. However, if any side effects subside or worsen, let your doctor know. Depending on the severity of the side effects, you might need to adjust your dose or switch medications altogether.

If you’re concerned about any specific side effects, discuss the benefits and risks with your doctor.

Should I take Lexapro for social anxiety?

If you struggle with social anxiety, Lexapro could help you. However, a psychiatrist will be your best guide in determining if Lexapro or a different medication would be best for you. They will educate you on the benefits and risks of medications and determine the best medication for social anxiety in your individual case. They will also take into consideration any co-occurring conditions that commonly present alongside social anxiety, such as generalized anxiety disorder, depression, and OCD (obsessive-compulsive disorder). On top of medication, psychotherapy is extremely beneficial for social anxiety.  

If you’re looking for a psychiatrist to treat your social anxiety disorder, consider Talkiatry. xWe’re a national psychiatry practice that treats a variety of mental health conditions, including social anxiety and co-occurring conditions. We provide virtual, in-network services so you can easily get the care you need from home. To get started, complete our free online assessment to get matched with a psychiatrist.  

FAQs

Is Lexapro good for social anxiety?

Lexapro is not FDA-approved for social anxiety treatment. However, when prescribed off-label, there is research that shows that Lexapro can help social anxiety symptoms. Every individual is different. Lexparo might be super helpful for one person’s social anxiety, but not for another’s.

Which SSRI is best for social anxiety?

There isn’t a definitive “best” SSRI for social anxiety since everyone responds differently to medications. However, the two SSRIs that are officially FDA-approved for social anxiety treatment with extensive clinical trials and research are Paxil and Zoloft.

How can you cope with social anxiety?

On top of taking medication for social anxiety, psychotherapy plays a huge role in coping with social anxiety. For many people, a combination of medications and therapy is the most effective. Types of psychotherapy for social anxiety disorder include:

  • Exposure therapy
  • Acceptance and commitment therapy (ACT)

Therapy will teach you coping skills and strategies to feel less anxious and more comfortable in social situations, helping you to gain confidence in your recovery.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Frequently asked questions

Does Talkiatry take my insurance?

We're in network with major insurers, including:

  • Aetna
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Even if your insurer isn't on the list, we might still accept it. Use the insurance eligibility checker in our online assessment to learn more.

Can I get an estimate of my visit cost?

The best way to get a detailed estimate of your cost is to contact your insurance company directly, since your cost will depend on the details of your insurance.  

For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

About
Brenda Camacho, MD

Dr. Brenda Y. Camacho holds the position of Staff Psychiatrist at Talkiatry. She is board-certified in Adult Psychiatry. She has been practicing for over 25 years.

While having treated a wide range of adult patients, Dr. Camacho’s primary focus is treating adult outpatients with mood or psychotic disorders. Her practice focuses on medication management. Typically, she offers this in conjunction with supportive or insight-oriented therapy in 30-minute follow-up visits. On occasion, Dr. Camacho will believe additional therapy is also needed and asks that you bring a therapist into your care team to provide the best outcome.

Dr. Camacho completed her undergraduate studies at Tufts University. She received her medical degree from Temple University School of Medicine in Philadelphia, PA and then continued with Temple for her residency in adult psychiatry. After completing training, Dr. Camacho worked at Cooper Hospital in Camden NJ as Associate Director of Consultation/Liaison Service and Psychiatry Residency Training and Co-Director of the Neuropsychiatry Clinic. She then began working exclusively in outpatient settings, joined NewPoint Behavioral Health Care, and served as Medical Director before and after their merge with Acenda Integrated Health.

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