The psychopharmacology of social phobia and comorbid disorders

The pharmacotherapy of social phobia includes agents from different classes with different mechanisms of action and has recently become the focus of more attention in the research community. The authors highlight drug treatments with reported efficacy, including: (1) certain antidepressants: monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and other antidepressants not yet available in the United States such as reversible inhibitors of MAO-A; (2) high-potency benzodiazepines; and (3) beta-adrenergic blocking drugs (mainly for performance anxiety). The frequent co-occurrence of social phobia with other psychiatric disorders often complicates patient management, treatment, and outcome. Rates of comorbidity, principles of pharmacotherapy for the comorbid condition, and the potential advantages and disadvantages of the aforementioned agents in social phobia patients suffering comorbid disorders are discussed.