Safety and Effectiveness of Escitalopram and Venlafaxine Sr in Social Anxiety Disorder Patients in Mardan, Pakistan: A Prospective Cohort Analysis

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Social Anxiety Disorder (SAD) is a widespread psychiatric condition characterized by fear and discomfort in social situations, often leading to panic attacks. SAD is influenced by biological, genetic, familial, and environmental factors and can result in severe mental health issues. It is most prevalent in third-world countries, impoverished communities, and among the unemployed. A prospective cohort study was conducted in the mardan district to assess the effectiveness and safety of escitalopram and venlafaxine in treating SAD. The study included 240 adult participants, with a higher prevalence of SAD in females, especially those aged 18 to 39. Both medications were found to reduce anxiety levels significantly. Venlafaxine was more effective than escitalopram, with a statistically significant reduction in mean social anxiety scores by using Himilton anxiety rating scale. Both drugs demonstrated good compliance rates, but mild adverse effects such as weight gain, xerostomia (dry mouth), and ejaculation dysfunction were reported. Venlafaxine and escitalopram are effective and safe treatments for SAD, with venlafaxine showing superior effectiveness. However, this study had limitations in terms of its sample size, so further multicenter studies with larger and more diverse populations in Pakistan are needed for generalizability.