Social anxiety disorder represents a substantial public health problem because is a relative common mental disorder and has a high prevalence and lifelong chronicity. The fact that serotonergic agents is considered to be effective for its treatment suggests that patients may have an abnormal serotonergic neurotransmission. Selective serotonin reuptake inhibitors are effective in the treatment of social anxiety disorder and are currently perceived as the pharmacotherapy of choice.

We investigated the efficacy and tolerability of escitalopram in the treatment of generalised social anxiety disorder.

Patients with generalised social anxiety disorder were randomised to receive placebo (n = 61) or10-20 mg escitalopram (n = 60) in a 12-week, double-blind study. The primary outcome measure was the mean change from baseline to last assessment in the Liebowitz Social Anxiety Scale (LSAS) total score.

The study showed a statistically superior therapeutic effect for escitalopram compared with placebo on the LSAS total score (p = 0.005).There were significantly more responders to treatment for escitalopram than for placebo (68% v. 28%; p < 0.005). The clinical relevance of these findings was supported by significant reduction in the work and social components of the Sheehan Disability Scale and by the good tolerability of escitalopram treatment.

These data suggest that escitalopram was efficacious and well tolerated in the treatment of social anxiety disorder. Further studies are needed on larger groups of patients to certify these results.