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[Social anxiety and propranolol abuse: a case study]
Bruno José Barcellos Fontanella1
1Laboratório de Pesquisas Clínico-Qualitativas, Departamento de Psicologia Médica e Psiquiatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil. bruno.fontanella@uol.com.br
Revista Brasileira De Psiquiatria (Sao Paulo, Brazil : 1999)
|August 26, 2004
Summary
This case study highlights the challenges individuals with severe social anxiety disorder face in seeking treatment. It suggests a potential rise in self-prescribed beta-blockers like propranolol for social anxiety symptoms.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Psychology
Background:
- Social anxiety disorder (SAD) is a prevalent mental health condition characterized by intense fear of social situations.
- Beta-blockers, such as propranolol, are sometimes used off-label for performance anxiety, but their long-term, unprescribed use in SAD is less understood.
Observation:
- A patient with severe SAD self-prescribed propranolol for six years at high doses (up to 320 mg/day).
- Despite self-treatment, generalized social anxiety symptoms persisted, indicating the limitations of unprescribed beta-blocker use.
- The patient showed improvement in both anxiety symptoms and propranolol misuse after initiating formal treatment with tranilcipromine and later paroxetine.
Findings:
- Formal psychiatric treatment, including monoamine oxidase inhibitors (MAOIs) like tranilcipromine and selective serotonin reuptake inhibitors (SSRIs) like paroxetine, proved effective in managing severe SAD.
- The case suggests that patients with SAD may face significant barriers to seeking professional help, leading to prolonged self-medication.
- The study hypothesizes an underrecognized trend of informal beta-blocker prescription for SAD and performance anxiety.
Implications:
- This case underscores the critical need for accessible and effective treatments for social anxiety disorder.
- It highlights the potential public health issue of unprescribed beta-blocker use in individuals with anxiety disorders.
- Further research is warranted to investigate the prevalence and impact of informal beta-blocker use in the SAD population.