Medication therapy for social phobia.
Social phobia, though the third most common psychiatric disorder in the United States, has received little systematic attention until recently. Chronic and disabling symptoms usually precede other disorders in individuals with comorbidity, including alcohol abuse. Though about 80% of individuals do not seek treatment, controlled trials have demonstrated efficacy for several medications, of which phenelzine (an irreversible monoamine oxidase inhibitor [MAOI]) is the best studied. The benzodiazepines, clonazepam and alprazolam, also hold promise. New reversible MAOIs such as moclobemide and brofaromine are under investigation; fluoxetine and other serotonin selective reuptake inhibitors need further controlled study. The benefits of group cognitive-behavioral therapy also appear substantial. Issues for future investigation include long-term outcome, differential therapeutics, diagnostic subtyping, and combination treatments.
Marshall
R D
RD
Anxiety Disorders Clinic, New York State Psychiatric Institute, New York 10032.
Schneier
F R
FR
Fallon
B A
BA
Feerick
J
J
Liebowitz
M R
MR
D001549:Benzamides / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D020912:Moclobemide; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D010624:Phenelzine / Q000627:therapeutic use; D010698:Phobic Disorders / Q000188:drug therapy* / Q000523:psychology; D010880:Piperidines / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D001549:Benzamides; D001569:Benzodiazepines; D005473:Fluoxetine; D020912:Moclobemide; D008996:Monoamine Oxidase Inhibitors; D010624:Phenelzine; D010880:Piperidines; D017367:Selective Serotonin Reuptake Inhibitors; C038213:brofaromine