Pharmacotherapy of social anxiety disorder.
BACKGROUND
Social anxiety disorder (SAD) is one of the most common psychiatric disorders, with a lifetime prevalence of 5-12%. Fears of scrutiny and embarrassment in social and public situations are accompanied by anxiety symptoms, avoidance behavior, and impairment in social and work functioning. Several classes of medication, as well as cognitive-behavioral therapies, have evidence for efficacy in the treatment of SAD, but only a minority of individuals with the disorder receives treatment.


METHODS
This review focuses on the evidence-based treatment of SAD with medications including serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, monoamine oxidase inhibitors, other antidepressants, benzodiazepines, alpha-delta calcium-channel agents, and beta-adrenergic blockers. It discusses clinical considerations in the selection and monitoring of treatments, including issues of safety, duration of treatment, comorbidity, and integration of medication with psychotherapeutic treatment. For this review, a PubMed literature search was conducted during July, 2010.


CONCLUSIONS
Medications in several classes have been demonstrated efficacious in the treatment of SAD. Treatment selection and implementation require attention to clinical diagnosis, patient education, and appropriate monitoring.
Columbia University College of Physicians and Surgeons, and Research Psychiatrist, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA. frs1@columbia.edu
Franklin R
FR
Schneier
D000818:Animals; D000928:Antidepressive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D019317:Evidence-Based Medicine; D006801:Humans; D010698:Phobic Disorders / Q000188:drug therapy* / Q000628:therapy
D000928:Antidepressive Agents; D001569:Benzodiazepines