Hyperhidrosis in social anxiety disorder.
OBJECTIVE
Excessive sweating (hyperhidrosis) is an overlooked and potentially disabling symptom, which is often seen in social anxiety disorder (SAD). We conducted a retrospective review of data acquired in patients with SAD who had participated in placebo-controlled clinical trials of fluoxetine, cognitive behavior therapy, clonazepam and gabapentin. Four specific topics were addressed: (1) overall levels of sweating; (2) characteristics of those with hyperhidrosis; (3) a comparison of active treatments relative to placebo on hyperhidrosis; and (4) an examination of baseline sweating severity as a predictor of treatment outcome.


METHODS
Using the Brief Social Phobia Scale (BSPS) and Social Phobia Inventory (SPIN), we examined the above questions.


RESULTS
Hyperhidrosis was found in 24.8-32.3% of 375 subjects assessed, depending upon the scale used. Hyperhidrosis was associated with higher levels of disability, fear, avoidance, and other physiologic symptoms. While treatment in general was associated with a reduction in the rate of hyperhidrosis from 23.7% to 9.7% (BSPS), and 34.0% to 15.5% (SPIN), only fluoxetine differed significantly from placebo in respect of change in sweating score from baseline to endpoint. In an ANCOVA, gabapentin differed from placebo on the SPIN.


CONCLUSIONS
We conclude that hyperhidrosis is frequently seen in patients with SAD, and that its response to treatment is variable. Further attention should be paid to the possible importance of this symptom in social anxiety.
Davidson
Jonathan R T
JR
Duke University Medical Center, Trent Drive, 4th Floor, Yellow Zone, Room 4082B, Box 3812, Durham, NC 27710, USA. jonathan.davidson@duke.edu
Foa
Edna B
EB
Connor
Kathryn M
KM
Churchill
L Erik
LE
D000085:Acetates / Q000494:pharmacology; D000328:Adult; D000588:Amines; D002121:Calcium Channel Blockers / Q000494:pharmacology; D002986:Clinical Trials as Topic; D002998:Clonazepam / Q000494:pharmacology; D015928:Cognitive Behavioral Therapy; D003509:Cyclohexanecarboxylic Acids; D005260:Female; D005473:Fluoxetine / Q000494:pharmacology; D018757:GABA Modulators / Q000494:pharmacology; D000077206:Gabapentin; D006801:Humans; D006945:Hyperhidrosis / Q000209:etiology / Q000523:psychology*; D008297:Male; D010698:Phobic Disorders / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D002121:Calcium Channel Blockers; D002998:Clonazepam; D003509:Cyclohexanecarboxylic Acids; D005473:Fluoxetine; D018757:GABA Modulators; D000077206:Gabapentin; D017367:Selective Serotonin Reuptake Inhibitors; D005680:gamma-Aminobutyric Acid