title: Treating individuals with social anxiety disorder and at-risk drinking: phasing in a brief alcohol intervention following paroxetine.
abstract: Paroxetine alone is not sufficient to decrease alcohol use in socially anxious alcoholics seeking anxiety treatment. We tested the hypothesis that adding a brief-alcohol-intervention (BI) to paroxetine would decrease alcohol use. All subjects (N=83) had a diagnosis of social anxiety disorder, endorsed drinking to cope with anxiety, were NIAAA-defined at-risk drinkers, and were randomized to either paroxetine alone, or paroxetine plus BI. Both groups showed significant improvement in both social anxiety severity (F(5,83)=61.5, p<0.0001) and drinking to cope (e.g. F(4,79)=23, p<0.0001) and these two constructs correlated with each other (B=3.39, SE=0.696, t(71)=4.88, p<0.001). BI was not effective at decreasing alcohol use (e.g. no main effect of group, all p values >0.3). Paroxetine decreased social anxiety severity in the face of heavy drinking and decreasing the anxiety was related to a concurrent decrease in coping related drinking. BI was not effective at decreasing drinking or drinking to cope.
authors.affiliation: Charleston Alcohol Research Center, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States. booksw@musc.edu
authors.forename: Sarah W
authors.initials: SW
authors.lastname: Book
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Thomas
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Smith
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Randall
authors.forename: Matt G
authors.initials: MG
authors.lastname: Kushner
authors.forename: Gail A
authors.initials: GA
authors.lastname: Bernstein
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Specker
authors.forename: Peter M
authors.initials: PM
authors.lastname: Miller
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Randall
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology / Q000628:therapy*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy* / Q000523:psychology; D001008:Anxiety Disorders; D003131:Combined Modality Therapy / Q000379:methods; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D017374:Paroxetine / Q000627:therapeutic use*; D010698:Phobic Disorders / Q000175:diagnosis; D012920:Social Behavior Disorders / Q000628:therapy*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D017374:Paroxetine