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This chapter summarizes the available evidence for the pharmacological management of social anxiety disorder (SAD). Monoamine oxidase inhibitors (MAOIs) were the first medications to be widely studied as a treatment for SAD. Six double-blind, placebo-controlled trials have consistently demonstrated the efficacy of phenelzine in the treatment of SAD, resulting in symptomatic and functional improvement. Compared with non-reversible MAOIs, reversible inhibitors of monoamine oxidase-A (RIMAs) have a significantly lower risk of potentiating the dangerous pressor effect of tyramine, which allows for relaxation or total elimination of dietary restrictions. Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) have been studied widely because of their efficacy, safety, and tolerability compared with earlier medications. The evidence from the reviewed clinical trials and meta-analyses suggests that a number of medications are efficacious in the treat.
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