The following is only a guide to what we have found to be clinically useful. However, empirical research in this area has tended to support these clinical findings.

In the first place, not everyone with social phobia needs to be on medication. There are many factors that need to enter into this judgment, such as severity of the condition, conferring with your anxiety specialist, your psychiatrist, other medications you take and your general medical condition, etc. and the way you know your body responds to medication in general.

When a socially-anxious person faces anxiety problems related to social anxiety every day of their lives we recommend that medication may be very useful. Please keep in mind that while medication can be very helpful in some cases, it is NOT a cure. It will not get you to where you want to be -- it will not be the "solution".

If we recommend medication it is for the purpose of using it as a "tool" or as an "encouragement" while undergoing cognitive-behavioral therapy. If medication allows the individual to practice better and clearer at home on CBT material and if the anxiety is cut somewhat in daily functioning, then medication can be powerful and helpful. It is the CBT however that changes your brain pathways (neural pathways) permanently, NOT the medication. Medication generally works faster (if it works), but permanent results (physiological changes) can only occur by learning to think and beginning to feel differently.  We use CBT to make these permanent changes.

If you are looking for a band-aid, get the medication and ignore CBT therapy.  In a few years, you will not be happy with your decision.

Again, in general, we prefer a combination of the right medication with CBT.  When both work in concert, progress is enhanced. 

If you are looking for a permanent solution -- a change in your brain's chemistry and neural pathways --  stick with CBT and practice, practice, practice until it becomes an automatic habit. There is research evidence showing that neural pathways actually change physiologically over time by using cognitive-behavioral therapy.

Medication changes brain chemistry temporarily; CBT has the power to make it permanent.

Each and every person responds individually to medication.  When medication is addressed, what works for one person may not work for another. Here we are only talking in generalities and in approximate percentages. If a medication works for you, as you are under the care of a qualified psychiatrist who specializes in the anxiety disorders, stick with it.

ADDITIONAL NOTE:  Research has demonstrated that "avoidant personality disorder" is simply a severe case of social phobia/social anxiety.  Avoidant personality disorder is NOT a psychotic condition, and the administration of anti-psychotic medication is therefore inappropriate.   These medications should not be used with uncomplicated social phobia/social anxiety.

IMPORTANT NOTICE: This information is intended as a general guide only. It is essential you consult with your psychiatrist about any medication, due to individual and/or interaction effects, and additional medical complications. It is also essential that you work with a psychiatrist that FULLY understands social anxiety and has kept up with the latest research on medical treatment for social anxiety.

Please notice that we are specifically referring here to people who have been correctly diagnosed as having social anxiety disorder or "social phobia" (DSM-IV: 300.23).