Approach to managing social anxiety disorder in adults and young people

Psychosocial interventions are first line for social anxiety disorder in adults and young people. Use pharmacotherapy as an adjunct to psychotherapy, or as an alternative if psychosocial interventions are not available, not effective or not preferred.

When evaluating treatment options for a young person, also consider:

• there are few data on psychotropic use in young people because young people are poorly represented in clinical trials
• young people are more susceptible to developing activation and suicidal thoughts when starting treatment with an antidepressant; this effect has been most often observed with selective serotonin reuptake inhibitors (SSRIs)
• if pharmacotherapy is used, it should ideally be started by a clinician with expertise in using psychotropics in young people.

For treatment considerations for females of childbearing potential, including advice on contraception, preconception planning and psychotropic use, see here.

For considerations in managing anxiety disorders such as social anxiety disorder during the perinatal period, see here or for considerations in partners, see here.