Nefazodone for social phobia: a clinical case series

A number of pharmacological agents, including the monoamine oxidase inhibitors, benzodiazepines, selective serotonin reuptake inhibitors, and beta blockers, have proven effective for the treatment of social phobia. Nefazodone, a relatively novel antidepressant, has demonstrated potential efficacy for the treatment of panic disorder but has not been formally studied in patients with social phobia. The authors conducted a clinical case study in which five consecutive patients meeting DSM-IV criteria for generalized social phobia were treated with nefazodone (dose range: 200-600 mg/day) for 3 months. Three of the patients completed all 3 months of the treatment, one discontinued after 2 1/2 months due to adverse gastrointestinal effects and one discontinued after 2 months due to lack of efficacy. The patients completed the Liebowitz. Social Phobia Scale and the Sheehan Disability Scale at every clinic visit, and were evaluated by the clinicians with the Brief Social Phobia Scale and CGI-Severity and CGI-Improvement scales. Analysis of endpoint data demonstrated significant improvement on most measures of outcome. Results from this case series suggest that nefazodone may be an effective treatment for social phobia and that formal randomized trials are warranted.