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Social anxiety disorder : current treatment recommendations
Jacqueline E Muller1, Liezl Koen, Soraya Seedat
1Medical Research Council's Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Tygerberg, Cape Town, South Africa. jemuller@sun.ac.za
CNS Drugs
|May 24, 2005
Summary
Selective serotonin reuptake inhibitors (SSRIs) and venlafaxine XR are effective first-line treatments for social anxiety disorder (SAD). Cognitive behavioral therapies also show promise, but optimal management for refractory cases needs more research.
Area of Science:
- Psychiatry
- Clinical Psychology
- Pharmacology
Background:
- Social anxiety disorder (SAD) is common and disabling, often co-occurring with other conditions.
- Advances in treatment options have emerged due to increased awareness over the past two decades.
Purpose of the Study:
- To review current pharmacotherapeutic and psychotherapeutic treatment options for generalized social anxiety disorder.
- To provide an evidence-based overview of first- and second-line treatments for SAD.
Main Methods:
- Review of randomized controlled trials and empirical evidence for SAD treatments.
- Analysis of data supporting the efficacy, safety, and tolerability of various pharmacological and psychological interventions.
Main Results:
- SSRIs are recommended as first-line treatment for generalized SAD due to proven efficacy, safety, and ability to manage co-morbidities.
- Venlafaxine XR is also emerging as a potential first-line option.
- Second-line treatments include MAOIs, reversible inhibitors of monoamine oxidase A, benzodiazepines, and antiepileptics.
- Cognitive behavioral therapies have strong empirical support.
Conclusions:
- SSRIs and potentially venlafaxine XR represent first-line pharmacotherapy for SAD.
- Cognitive behavioral therapies are empirically supported psychotherapeutic options.
- Further research is needed to determine optimal management strategies for treatment-refractory SAD.