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Int J Neuropsychopharmacol. 2003 Dec;6(4):427-42.

The evidence-based pharmacological treatment of social anxiety disorder.

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1
Department of Psychiatry of Columbia College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, NY, USA. cb255@columbia.edu

Abstract

Social anxiety disorder (SAD) is a highly prevalent and often disabling disorder. This paper reviews the pharmacological treatment of SAD based on published placebo-controlled studies and published meta-analyses. It addresses three specific questions: What is the first-line treatment of SAD? How long should treatment last? What should be the management of treatment-resistant cases? Based on their efficacy for SAD and common comorbid disorders, tolerability, and safety, SSRIs should be considered as the first-line treatment for most patients. Less information is available regarding the optimal length of treatment, although individuals who discontinue treatment after 12-20 wk appear more likely to relapse than those who continue on medication. Even less empirical evidence is available to support strategies for treatment-resistant cases. Clinical experience suggests that SSRI non-responders may benefit from augmentation with benzodiazepines or gabapentin, or from switching to MAOIs, RIMAs, benzodiazepines or gabapentin. Cognitive-behavioural therapy may also be a helpful adjunct or alternative.

PMID:
14609440
DOI:
10.1017/S1461145703003791
[Indexed for MEDLINE]
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