Does sertraline cure social anxiety disorder (SAD)?

In this article, we will discuss whether sertraline can be used for the management and treatment of social anxiety disorder. We will also discuss some research studies and common dosage recommendations for this antidepressant for SAD.

Does sertraline cure social anxiety disorder (SAD)?

Yes, sertraline can be used for the management and treatment of Social Anxiety Disorder (SAD), also known as social phobia. Sertraline is approved by the Food and Drug Administration (FDA) for the management of social anxiety, depression, and several other mental health conditions (1,2). 

As an antidepressant, sertraline balances serotonin levels in the brain. Serotonin is an excitatory monoamine neurotransmitter involved in the pathophysiology of SAD. Balancing serotonin levels can help control the symptoms of SAD.

However, it’s crucial to note that sertraline is a prescription medication and should never be taken without a doctor’s approval. Additionally, sertraline may not suit everyone, as what works for one person may not work for another. It’s best to avoid self-medicating and trust your doctor’s expertise in managing your symptoms.

What does research suggest?

Several research studies have investigated the effects of sertraline on social anxiety, as it is one of the FDA-approved uses of this antidepressant. A double-blinded research study indicated that sertraline is a safe and effective option for managing symptoms associated with social anxiety (3). 

The overall duration of the study was 10 weeks, during which doses between 50-200 mg were prescribed, depending on the individual.

Another research study included over 200 patients who took sertraline over 12 weeks for Social Anxiety Disorder (SAD) (4). The study showed significant improvement in social anxiety with the use of sertraline. Less than 10% of people discontinued the drug because of adverse events, and it was generally well-tolerated.

Another research study indicated that sertraline is an effective option, which can be used safely in the long term, for the management of generalised social phobia (5). 

These studies collectively suggest that sertraline is a good option for people who struggle with social phobia, and this is why the FDA approved this drug for managing this condition.

What are the dosage recommendations of sertraline for SAD?

The dosage recommendations of sertraline for SAD are: (1,2)

Age groupStarting doseTypical target dose rangeMaximum daily dose
Adults25 mg once daily50 mg to 200 mg once daily200 mg
Adolescents25 mg once daily50 mg to 200 mg once daily200 mg
Children The dose must be determined by a healthcare professional. 

The above-mentioned dosage recommendations can vary from person to person and should be determined by a qualified healthcare provider.

What are the side effects of sertraline when used for SAD?

Sertraline is associated with the following side effects when used for social anxiety disorder: (1,2)

  • headache
  • dizziness
  • excessive tiredness
  • nervousness
  • Tremors 
  • dry mouth
  • heartburn
  • Insomnia 
  • constipation
  • diarrhoea
  • nausea
  • vomiting
  • loss of appetite
  • weight changes
  • Excessive sweating
  • Sexual side effects

Zoloft can cause serious side effects in some individuals which may require immediate medical attention. 

What to do if sertraline fails to manage your SAD?

If sertraline fails to manage your social anxiety, please reach out to your provider. It’s important to note that sertraline takes time to work and doesn’t provide immediate relief. Typically, it takes 4-6 weeks for sertraline to show its full effects in managing depression. 

However, individuals with social anxiety may begin to feel better around week 2 or 3. The response time can vary among individuals. If you’re a new user and don’t see positive changes, give the medication time to take effect.

If you experience side effects that affect compliance, discuss them with your provider. Dose reduction may help some, as individuals new to antidepressants may develop early side effects. However, it’s crucial to recognize that sertraline may not suit everyone. 

Some may experience disturbing side effects leading to discontinuation. If not tolerating sertraline well, your doctor will consider alternative treatment options. For mild social anxiety disorder (SAD), low-dose sertraline and psychotherapy can be effective.

Managing social anxiety with sertraline

In my experience as a pharmacist, people often overlook psychotherapy, favouring medications. While medications help manage clinical symptoms, psychotherapy is highly beneficial. Many patients do well with psychotherapy alone or with a low dose of sertraline (25 mg). 

The standard therapeutic dose is 50 mg, but for SAD, 25 mg paired with counselling sessions and a healthy lifestyle can be effective. Our brains control almost every part of our bodies, and with the right therapeutic approach, we can train them. 

Don’t rely solely on medication – behavioural therapies and facing social fears can aid in overcoming SAD. Sertraline is a safe and effective choice for managing social anxiety.

References 

  1. Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689
  2. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf
  3. Katzelnick DJ, Kobak KA, Greist JH, Jefferson JW, Mantle JM, Serlin RC. Sertraline for social phobia: a double-blind, placebo-controlled crossover study. Am J Psychiatry. 1995 Sep;152(9):1368-71. doi: 10.1176/ajp.152.9.1368. PMID: 7653696. https://pubmed.ncbi.nlm.nih.gov/7653696/
  4. Liebowitz MR, DeMartinis NA, Weihs K, Londborg PD, Smith WT, Chung H, Fayyad R, Clary CM. Efficacy of sertraline in severe generalized social anxiety disorder: results of a double-blind, placebo-controlled study. J Clin Psychiatry. 2003 Jul;64(7):785-92. doi: 10.4088/jcp.v64n0708. PMID: 12934979. https://pubmed.ncbi.nlm.nih.gov/12934979/
  5. Van Ameringen MA, Lane RM, Walker JR, Bowen RC, Chokka PR, Goldner EM, Johnston DG, Lavallee YJ, Nandy S, Pecknold JC, Hadrava V, Swinson RP. Sertraline treatment of generalized social phobia: a 20-week, double-blind, placebo-controlled study. Am J Psychiatry. 2001 Feb;158(2):275-81. doi: 10.1176/appi.ajp.158.2.275. PMID: 11156811. https://pubmed.ncbi.nlm.nih.gov/11156811/ 

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