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Pharmacotherapy of social anxiety disorder: what does the evidence tell us?

Publication ,  Conference
Davidson, JRT
Published in: J Clin Psychiatry
2006

The treatment goals for social anxiety disorder (SAD) are to reduce fear, avoidance, physical distress, disability, and comorbidity. This review illustrates some of the primary studies used to evaluate efficacy of treatments for SAD. The selective serotonin reuptake inhibitors (SSRIs) paroxetine, sertraline, fluoxetine, fluvoxamine, and escitalopram and the serotonin-norepinephrine reuptake inhibitor venlafaxine are effective treatments. They have the additional benefit of being able to treat comorbid conditions. For people who do not respond to serotonin reuptake inhibitors, treatment options include benzodiazepines (clonazepam, alprazolam, and bromazepam), alpha2delta calcium-channel blockers (gabapentin and pregabalin), reversible inhibitors of monoamine oxidase A (moclobemide, although agents in this class are not available in the United States), antiepileptics (levetiracetam), and atypical antipsychotics (olanzapine). The irreversible monoamine oxidase inhibitor phenelzine can be considered an effective third-line therapy. Combination treatments may be beneficial, but more research is needed. Benefits of beta-blockers (propranolol and atenolol) are limited to performance anxiety. Botulinum toxin A may be an effective augmentation treatment option for severe axillary hyperhidrosis in patients with SAD. Studies show that patients with SAD who are maintained on paroxetine, sertraline, or clonazepam have a low relapse rate.

Duke Scholars

Published In

J Clin Psychiatry

ISSN

0160-6689

Publication Date

2006

Volume

67 Suppl 12

Start / End Page

20 / 26

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Sertraline
  • Secondary Prevention
  • Psychotropic Drugs
  • Psychiatry
  • Phobic Disorders
  • Paroxetine
  • Humans
  • Drug Therapy, Combination
  • Comorbidity
 

Citation

APA
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ICMJE
MLA
NLM
Davidson, J. R. T. (2006). Pharmacotherapy of social anxiety disorder: what does the evidence tell us? In J Clin Psychiatry (Vol. 67 Suppl 12, pp. 20–26). United States.
Davidson, Jonathan R. T. “Pharmacotherapy of social anxiety disorder: what does the evidence tell us?” In J Clin Psychiatry, 67 Suppl 12:20–26, 2006.
Davidson JRT. Pharmacotherapy of social anxiety disorder: what does the evidence tell us? In: J Clin Psychiatry. 2006. p. 20–6.
Davidson, Jonathan R. T. “Pharmacotherapy of social anxiety disorder: what does the evidence tell us?J Clin Psychiatry, vol. 67 Suppl 12, 2006, pp. 20–26.
Davidson JRT. Pharmacotherapy of social anxiety disorder: what does the evidence tell us? J Clin Psychiatry. 2006. p. 20–26.

Published In

J Clin Psychiatry

ISSN

0160-6689

Publication Date

2006

Volume

67 Suppl 12

Start / End Page

20 / 26

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Sertraline
  • Secondary Prevention
  • Psychotropic Drugs
  • Psychiatry
  • Phobic Disorders
  • Paroxetine
  • Humans
  • Drug Therapy, Combination
  • Comorbidity