Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-18T08:48:08.020Z Has data issue: false hasContentIssue false
  • English
  • Français

Pharmacotherapy for Social Phobia: What Works, What Might Work, and What Does Not Work at All

Published online by Cambridge University Press:  07 November 2014

Michael Van Ameringen ,
Catherine Mancini ,
Peter Farvolden  and
Jonathan Oakman
Get access Rights & Permissions [Opens in a new window]

Abstract

Social phobia is a common psychiatric disorder that is often associated with significant psychiatric comorbidity and disability. In the past, clinicians have underutilized pharmacotherapy as a treatment option for this disorder. This article provides a review of current pharmacotherapeutic options for social phobia, including a review of the results to date of numerous controlled trials, a description of the recent results of open trials of new and promising agents, and a summary of the information available on the use of pharmacotherapy in the treatment of children and adolescents.

Type
Feature Articles
Information
CNS Spectrums , Volume 4 , Issue 11: Social Phobia , November 1999 , pp. 61 - 68
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington DC: American Psychiatric Press; 1994.Google Scholar
2.Kessler, RC, McGonagle, KA, Zhao, S, et al.Lifetime and 12-month prevalence of D5M-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8–19.CrossRefGoogle ScholarPubMed
3.Schneier, FR, Johnson, J, Homig, CD, et al.Social phobia: comorbidity and morbidity in an epidemiologic sample. Gen Psychiatry. 1992;49:282–288.CrossRefGoogle Scholar
4.Katzelnick, DJ, Kobak, KA, Helstad, CP, et al. The direct and indirect costs of social phobia in managed care patients. Presented at 19th National Conference of the Anxiety Disorders Association of America; March 25-28, 1999; San Diego, Calif.Google Scholar
5.Liebowitz, MR, Gorman, JM, Fyer, AJ, et al.Social phobia: review of a neglected anxiety disorder. Arch Gen Psychiatry. 1985;42:729–736.CrossRefGoogle ScholarPubMed
6.Van Ameringen, M, Mancini, C, Wilson, C, et al. The prevalence of school dropouts in an anxiety disorders clinic. Presented at 148th Annual Meeting of the American Psychiatric Association; May 24, 1995; Miami, Fla.Google Scholar
7.Van Ameringen, M, Mancini, C, Styan, G, et al.Major depression in patients with social phobia. Am J Psychiatry. 1990;147:637–639.Google Scholar
8.Robins, L, Helyer, JE, Weissman, MM, et al.Lifetime prevalence of specific phychiatric disorders in three sites. Arch Gen Psychiatry. 1984;41:949–958.CrossRefGoogle Scholar
9.Albano, AM. Cognitive-behavioral interventions with socially phobic children. Presented at 5th Internet World Conference on Biomedical Sciences; December 7-16, 1998; Ontario, Canada.Google Scholar
10.Heimberg, RG, Juster, HR. Cognitive behavioural treatments: literature review. In: Heimberg, RG, Liebowitz, MR, Hope, DA, Schneier, FR, eds. Social Phobia: Diagnosis Assessment and Treatment. New York, NY: Guilford Press; 1995:261–309.Google Scholar
11.Taylor, S. Meta-analysis of cognitive-behavioural treatments for social phobia. J Behav Ther Exp Psychiatr. 1996;27:1–9.CrossRefGoogle Scholar
12.Gelemter, CS, Uhde, TW, Cimbolic, P, et al.Cognitivebehavioral and pharmacological treatments of social phobia: a controlled study. Arch Gen Psychiatry. 1991;48:938–945.CrossRefGoogle Scholar
13.Liebowitz, MR, Schneier, P, Campeas, R, et al.Phenelzine vs atenolol in social phobia: a placebo controlled trial. Arch Gen Psychiatry. 1992;49:290–300.CrossRefGoogle Scholar
14.van Vliet, LM, Den Boer, JA, Westenberg, HGM. Psychopharmacological treatment of social phobia clinical and biochemical effects of brofaromine, a selective MOA-A inhibitor. Eur Neuropsychopharmacol. 1992;2:21–29.CrossRefGoogle Scholar
15.Fahlen, T, Nilsson, HL, Borg, K, et al.Social phobia: the clinical efficacy and tolerability of the monoamine oxidase-A and serotonin uptake inhibitor brofaromine: a double-blind placebo-controlled study. Acta Psychiatr Scand. 1995;92:351–358.CrossRefGoogle ScholarPubMed
16.Lott, M, Greist, JH, Jefferson, JW, et al.Brofaromine for social phobia: a multicenter, placebo-controlled, doubleblind study. J Clin Psychopharmacol. 1997;17:255–260.CrossRefGoogle Scholar
17.Versiani, M, Nardi, AE, Mundion, FD, et al.Pharmacotherapy of social phobia: a controlled study with moclobemide and phenelzine. Br J Psychiatry. 1992;161:353–360.CrossRefGoogle ScholarPubMed
18.Schneier, FR, Goetz, D, Campeas, BF, et al.Placebo controlled trial of moclobemide in social phobia. Br J Psychiatry. 1998;172:70–77.CrossRefGoogle ScholarPubMed
19.Noyes, R, Moroz, G, Davidson, JR, et al.Moclobemide in social phobia: a controlled dose-response trial. J Clin Psychopharmacol. 1997;17:247–254.CrossRefGoogle ScholarPubMed
20.The International Multicenter Clinical Trial Group on Moclobemide in Social Phobia. Moclobemide in social phobia: a double-blind, placebo-controlled clinical study. Eur Arch Psychiatry Clin Neurosci. 1997;247:71–80.CrossRefGoogle Scholar
21.Stein, MB. Medication treatments for panic disorder and social phobia. Depress Anxiety. 1998;7:134–138.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
22.Davidson, JRT, Potts, NS, Richichi, E, et al.Treatment of social phobia with clonazepam and placebo. J Clin Psychopharmacol. 1993;13:423–428.CrossRefGoogle ScholarPubMed
23.van Vliet, LM, Den Boer, J, Westenberg, HGM. Psychopharmacological treatment of social phobia: a double-blind placebo controlled study with fluvoxamine. Psychopharmacology. 1994;115:128–134.CrossRefGoogle ScholarPubMed
24.Stein, MB, Fyer, AJ, Davidson, JRT, et al.Fluvoxamine in the treatment of social phobia: a double-blind, placebocontrolled study. Am J Psychiatry. 1999;156:756–760.CrossRefGoogle Scholar
25.Katzelnick, DJ, Kobak, KA, Greist, JH, et al.Sertraline for social phobia: a double-blind, placebo-controlled crossover study. Am J Psychiatry. 1995;152:1368–1371.Google ScholarPubMed
26.Katzelnick, DJ, Kobak, KA, Greist, JH, Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. Washington, DC: American Psychiatric Association; 1980.Google Scholar
27.Van Ameringen, M, Swinson, R, Walker, JR, Lane, RM. A placebo-controlled study of sertraline in generalized social phobia. Presented at: 19th National Conference of the Anxiety Disorders Association of America; March 25-28, 1999; San Diego, Calif.Google Scholar
28.Blomhoff, S, Haug, TT, Humble, M, et al. Treatment of generalized social phobia. Presented at: 152nd Annual Meeting of the American Psychiatric Association; May 20, 1999; Washington, DC.Google Scholar
29.Stein, M, Liebowitz, M, Lydiard, B, et al.Paroxetine in the treatment of generalized social phobia (social anxiety disorder). JAMA. 1998;280:708–713.CrossRefGoogle ScholarPubMed
30.Baldwin, D, Bobes, J, Stein, DJ, Scharwachter, I, Faure, M. Paroxetine in social phobia/social anxiety disorder. Br J Psychiatry. 1999;175:120–126.CrossRefGoogle ScholarPubMed
31.Allgulander, C. Paroxetine in social anxiety disorder: a randomized placebo-controlled study. Acta Psychiatr Scand. 1990;100:193–198.CrossRefGoogle Scholar
32.Clarke, DB, Agras, WS. The assessment and treatment of performance anxiety in musicians. Am J Psychiatry. 1991;148:598–605.Google Scholar
33.Diagnostic and Statistical Manual of Mental Disorders. 3rd ed rev. Washington, DC: American Psychiatric Association; 1987.Google Scholar
34.van Vliet, LM, den Boer, JA, Westenberg, HGM, et al.Clinical effects of buspirone in social phobia: a doubleblind placebo-controlled study. J Clin Psychiatry. 1997;58:164–168.CrossRefGoogle ScholarPubMed
35.Emmanuel, NP, Johnson, M, Villareal, G. Imipramine in the treatment of social phobia: a double blind study. Presented at: 36th Annual Meeting of the American College of Neuropsychopharmacology; December 8-12, 1998; Kamuela, Hawaii.Google Scholar
36.Falloon, IR, Lloyd, GG, Harpin, R. The treatment of social phobia: real-life rehearsal with non-professional therapists. J Nerv Ment Dis. 1981;169:180–184.CrossRefGoogle Scholar
37.Turner, SM, Beidel, DC, Jacob, RG. Social phobia: a comparison of behavior therapy and atenolol. J Consult Clin Psychol 1994;62:350–358.CrossRefGoogle ScholarPubMed
38.Bell, J, DeVeaugh-Geiss, J. Multicenter trial of a 5-HT3 antagonist, ondansetron, in social phobia. Presented at: 33rd Annual Meeting of the American College of Neuropsychopharmacology; December 12-16, 1994; San Juan, Puerto Rico.Google Scholar
39.Pande, AC, Davidson, JR, Jefferson, JW, et al.Treatment of social phobia with gabapentin: a placebo-controlled study. J Clin Psychopharmacol. 1999;19:341–348.CrossRefGoogle ScholarPubMed
40.Van Ameringen, M, Mancini, C, Oakman, J. Nefazodone in the treatment of social phobia. J Clin Psychiatry. 1999;60:96–100.CrossRefGoogle ScholarPubMed
41.Worthington, JJ III, Zucker, BG, Calvin, SL, Fones, CSL, Otto, MW, Pollack, MENefazodone for social phobia: a clinical case series. Depress Anxiety. 1998;8:131–133.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
42.Emmanuel, NP, Czepowicz, VC, Ware, MR, et al. Venlafaxine in social phobia: a case series. [abstract]. 148th Annual Meeting of the American Psychiatric Association; May 24, 1995; Miami, Fla. Abstract NR373:156.Google Scholar
43.Kelsey, JE. Venlafaxine in social phobia. Psychopharmacol Bull. 1995;31:767–771.Google ScholarPubMed
44.van Vliet, IM, Westenberg, HGM, van Megen, HJGM. Clinical effects of venlafaxine in social phobia. Presented at: 11th Congress of the European College of Neuropsychopharmacology (ECNP); October 31-November 4, 1998; Paris, France.CrossRefGoogle Scholar
45.Altamura, AC, Pioli, R, Vitto, M, Mannu, P. Venlafaxine in social phobia: a study in selective serotonin reuptake inhibitor non-respnders. Int Clin Psychopharmacol. 1999;14:239–245.CrossRefGoogle Scholar
46.Emmanuel, NP, Lydiard, RB, Ballenger, JC. Treatment of social phobia with bupropion (letter). J Clin Psychopharmacol. 1991;11:276–277.CrossRefGoogle Scholar
47.Simpson, HB, Schneier, FR, Marshall, RD, et al.Low dose selegiline (L-deprenyl) in social phobia. Depress Anxiety. 1998;7:126–129.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
48.Goldstein, S. Treatment of social phobia with clonidine. Biol Psychiatry. 1987;22:369–372.CrossRefGoogle ScholarPubMed
49.Nardi, AE, Mendlowicz, M, Figueira, I, Versiani, M. Valproic acid in social phobia-an open trial. Presented at: 6th World Congress of Biological Psychiatry; June 22-27, 1999; Nice, France.Google Scholar
50.Albano, AM, Di Bartolo, PM, Heimberg, RG, et al.Children and adolescents: assessment and treatment. In: Heimberg, RG, Liebowitz, MR, Hope, DA, et al, eds. Social Phobia: Diagnosis, Assessment, and Treatment. New York, NY: Guilford Press; 1992.Google Scholar
51.Christoff, KA, Scott, WON, Kelley, ML, et al.Social skills and social problem-solving training for shy young adolescents. Behav Ther. 1985;16:468–477.CrossRefGoogle Scholar
52.Franco, DP, Christoff, KA, Crimmins, DE, et al.Social skills training for an extremely shy young adolescent: an empirical case study. Behav Ther. 1983;14:568–575.CrossRefGoogle Scholar
53.Simeon, JG, Ferguson, HB. Alprazolam effects in children with anxiety disorders. Can J Psychiatry. 1987;32:570–574.CrossRefGoogle ScholarPubMed
54.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
55.Simeon, JG, Ferguson, HB, Knott, V, et al.Clinical, cognitive, and neurophysiological effects of alprazolam in children and adolescents with overanxious and avoidant disorders. J Am Acad Child Adolesc Psychiatry. 1992;31:29–33.CrossRefGoogle ScholarPubMed
56.Kutcher, SP, Reiter, S, Gardner, DM, Klein, RG. The pharmacotherapy of anxiety disorders in children and adolescents. Psychiatr Clin North Am. 1992;15:41–67.CrossRefGoogle ScholarPubMed
57.Bernstein, GA, Borchardt, CM, Perwein, AR. Anxiety disorders in children and adolescents: a review of the past ten years. J Am Acad Child Adolesc Psychiatry. 1996;35:1110–1119.CrossRefGoogle Scholar
58.Ryan, ND, Puig-Antich, J. Pharmacological treatment of adolescent psychiatric disorders. J Adolesc Health Care. 1987;8:137–142.CrossRefGoogle ScholarPubMed
59.Popper, CW. Psychopharmacologic treatment of anxiety disorders in adolescents and children. J Clin Psychiatry, 1993;54:52–63.Google ScholarPubMed
60.Manassis, K, Bradley, S. Fluoxetine in anxiety disorders (letter). J Am Acad Child Adolesc Psychiatry. 1994;33:761–762.CrossRefGoogle Scholar
61.Birmaher, B, Waterman, GS, Ryan, N, et al.Fluoxetine for childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry. 1994;33:993–999.CrossRefGoogle ScholarPubMed
62.Black, B, Uhde, TW. Elective mutism as a variant of social phobia. J Am Acad Child Adolesc Psychiatry. 1990;31:1090–1094.CrossRefGoogle Scholar
63.Golwyn, H, Weinstock, RC. Phenelzine treatment of elective mutism. J Clin Psychiatry. 1990;51:384–385.Google ScholarPubMed
64.Black, B, Uhde, T. Treatment of elective mutism with fluoxetine: a double-blind, placebo controlled study. J Am Acad Child Adolesc Psychiatry. 1994;33:1000–1006.CrossRefGoogle ScholarPubMed
65.Mancini, C, Van Ameringen, M, Oakman, J, Farvolden, P. Serotonergic agents in the treatment of social phobia in children and adolescents: a case series. Depress Anxiety. 1999;10:33–39.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
66.March, JS, Biederman, J, Wolkow, R, et al.Seitraline in children and adolescents with obsessive-compulsive disorder a multicenter randomized controlled trial. JAMA. 1998;280:1752–1756.CrossRefGoogle ScholarPubMed
67.Liebowitz, MR, Gorman, JM, Fyer, AJ, Klein, DF. Social phobia: review of a neglected anxiety disorder. Arch Gen Psychiatry. 1985;42:729–735.CrossRefGoogle ScholarPubMed
68.Connor, KM, Davidson, JRT, Potts, NLS, et al.Discontinuation of clonazepam in the treatment of social phobia. J Clin Psychopharmacol. 1998;18:373–378.CrossRefGoogle ScholarPubMed
69.Stein, MB, Chartier, MJ, Hazen, AL, et al.Paroxetine in the treatment of generalized social phobia: open-label treatment and double-blind placebo-controlled discontinuation. J Clin Psychopharmacol. 1996;16:218–222.CrossRefGoogle ScholarPubMed
70.Van Ameringen, M, Mancini, C, Wilson, C. Buspirone augmentation of selective serotonin reuptake inhibitors (SSRIs)in social phobia. J Affect Disord. 1996;39:115–121.CrossRefGoogle Scholar