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Social anxiety
Current Medicines
Dveniz (Desvenlafaxine) 50 mg – 1 tablet at night and taken propanalol 40 but it is not helping.
Main Problems
Social Anxiety
Group me bolne me hesitation
Performance Anxiety
Presentation, meeting ya group discussion me bolne me difficulty
Mind blank i.e. hesitation
Fear of being judged
Situational Anxiety
Specific situations me anxiety badh jati hai (meeting, group discussion, public speaking, authority figures se baat karna)
Anticipatory anxiety (event se pehle hi sochna). is there any specific meds which cater mainly social anxiety like paroxetine for long term? specific answer please
Answers (7)
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Answered
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On the base history, social anxiety disorder with performance anxiety. If desvenlafaxine 50 mg and propranolol 40 mg have not been effective after an adequate trial, assess adherence, optimize the dose or consider switching medication, and recommend CBT with exposure therapy. Advise follow-up with the treating psychiatrist before making any medication changes.
Next Steps
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Answered
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The core complaints—intense fear of judgment, mind blanking, severe hesitation during group discussions, and high anticipatory anxiety—point directly to a classic presentation of Social Anxiety Disorder (SAD) with prominent performance anxiety features.
To answer your specific question directly: Yes, there are medications that cater more specifically to long-term social anxiety than Desvenlafaxine 50 mg, and Paroxetine is one of the premier, FDA-approved first-line choices. While Desvenlafaxine (an SNRI) is an excellent antidepressant, standard Selective Serotonin Reuptake Inhibitors (SSRIs) like Paroxetine or Sertraline, and SNRIs like Venlafaxine, carry much more extensive, robust empirical evidence and formal indications specifically for social anxiety. Furthermore, your current Propropanolol 40mg is likely failing because it only dampens peripheral autonomic symptoms (like a racing heart or tremors) on an on-demand basis—it does not alter the core cognitive distortions, "mind blanking," or the overwhelming fear of evaluation that is driving your distress.
Next Steps
Consult Your Treating Psychiatrist for a Regimen Review: Schedule a follow-up to discuss the lack of efficacy you are experiencing. Present the option of a structured cross-taper from Desvenlafaxine to an anti-anxiety specific first-line SSRI like Paroxetine or Sertraline.
Optimize the Propropanolol Protocol: Speak to your doctor about how you are taking Propropanolol. For performance anxiety, it is typically taken as a targeted, situational tool roughly 30 to 60 minutes before a public speaking event or meeting, rather than as a baseline preventative for cognitive worry.
Initiate Cognitive Behavioral Therapy (CBT): Medications can reduce the baseline chemical vulnerability, but CBT focused on Exposure and Response Prevention (ERP) and cognitive restructuring is essential to permanently stop "mind blanking" and rewrite your brain's response to social evaluation.
Health Tips
Never initiate, stop, or cross-taper between Desvenlafaxine and Paroxetine on your own. Abruptly switching these medications can induce a highly distressing discontinuation syndrome (dizziness, brain zaps, extreme irritability) or trigger severe rebound anxiety. Any change must be micro-tapered under professional supervision.
Reframe the "Mind Blanking": When your mind goes blank in a meeting, recognize it as a temporary surge of adrenaline shutting down your prefrontal cortex. Taking three slow, prolonged exhalations at your desk will signal safety to your amygdala and help bring your cognitive faculties back online.
Answered
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