Category Archives: Social Phobia

Treatments for Social Phobia

Social phobia was first described as a unique, diagnosable disorder in DSM-III (American Psychiatric Association 1980). From a historical perspective, the disorder has been recognized since the middle of the 19th century, when Casper described erythrophobia (Casper 1902). Marks (1970) separated social phobia from other types of anxiety, including agoraphobia and simple phobia; thus, he… Read More »

Treatments for Social Phobia: SSRIs

Pharmacological Studies The selective serotonin reuptake inhibitors (SSRIs) have received increased attention in the treatment of anxiety disorders. With the recent Food and Drug Administration (FDA) approval of fluoxetine and fluvoxamine in the treatment of obsessive-compulsive disorder, it has been made clear that this class of drugs has utility reaching beyond its primary indication of… Read More »

Irreversible, Nonselective Monoamine Oxidase Inhibitors

The suggestion that monoamine oxidase inhibitors might have efficacy in the treatment of social phobia first came from two different sources. One line of evidence consisted of four placebo-controlled studies of phenelzine on mixed phobic populations. Although those studies had important methodological problems, such as lack of operationalized diagnostic criteria, small sample sizes, and use… Read More »

Reversible Inhibitors of Monoamine Oxidase-A

The use of standard nonreversible monoamine oxidase inhibitors is limited by their side effects, especially the risk of hypertensive crisis if dietary restrictions are not followed. This led to the development of the reversible inhibitors of MAO-A (RIMAs), which have a significantly lower ability to potentiate the pressor effect of tyramine. This allows for relaxation… Read More »

Moclobemide for Social Phobia

Four double-blind, placebo-controlled of studies of moclobemide have been published, with mixed results. In the aforementioned study by Versiani and coworkers (1992), moclobemide was superior to placebo on the LSAS, Clinical Global Impressions Scale, Social Avoidance and Distress Scale, and Willoughby Personality Inventory, an index of social anxiety, at the end of week 8. Moclobemide… Read More »

SSRIs for Social Phobia

The success of selective serotonin reuptake inhibitors (SSRIs) in the treatment of depression and their favorable side-effect profile have stimulated clinicians to find new applications for these medications. The usefulness of the monoamine oxidase inhibitor class of antidepressants in the treatment of social phobia and the improvement in social functioning in patients whose major depression… Read More »

Benzodiazepines for Social Phobia

Since the development of chlordiazepoxide, benzodiazepines are known to have anxiolytic properties. Benzodiazepines had been shown useful in the treatment of generalized anxiety disorder and panic disorder. A logical extension was to assess their usefulness in social phobia. However, the first reports of the efficacy of benzodiazepines for social phobia only appeared in the literature… Read More »

Beta-Adrenergic Blockers for Social Phobia

Beta-adrenergic blockers came into use initially as a treatment for cardiac conditions and subsequently showed efficacy in the treatment of essential tremor. Later studies showed a connection between anxiety, signs and symptoms of peripheral arousal, and increased plasma levels of norepinephrine. This led to (beta-blocker trials in nonclinical samples of performers with high levels of… Read More »

Other Medications for Social Phobia

Buspirone for Social Phobia Some studies have shown that the anxiolytic effects of buspirone can be as effective as those of benzodiazepines in the treatment of generalized anxiety disorder, with less addiction liability. Buspirone is an azaspirone that acts as a full agonist on the serotonin type 1A (5-HT1A) autoreceptor and as a partial agonist… Read More »

Medication Selection for Social Phobia

Until 1985, little was known about psychopharmacotherapy for social phobia. At present, evidence indicates that several drugs may be useful in the treatment of that disorder. Twenty double-blind, placebo-controlled studies have been published to date, evaluating 10 drugs (phenelzine = 4, brofaromine = 3, moclobemide = 4, clonazepam = 1, alprazolam = 1, atenolol =… Read More »