Clinical Question What are the m...

Clinical Question

What are the meanings of medications for social phobia?

Evidence-Based Answer

In adults, medications may improve the symptoms of social phobia in the short bourn but their usefulness may be overstated because of publication bias. Selective serotonin reuptake inhibitors (SSRIs) have the strongest evidence of efficacy and the chiefly favorable side-effect profile.

Practice Pointers

Social phobia affects about 53 million Americans. [i]role[/i]s with social phobia fear and avoid social situations or doing things in assurance of others. It may be limited to cer-tain situations of that kind as public speaking, or it can be generalized. any persons have such severe fear that they are unable to work or leave their domiciles Stein and colleagues searched for published and unpublished trials of pharmacotherapy for treatment of social phobia.

A total of 36 randomized controll trials (RCTs) with 4268 patients were lay the foundation of Most of the RCTs followed patients for les than 14 weeks, and 17 of the studies reviewed SSRIs. A variety of other medications were studied, including monoamine oxidase inhibitors (MAOIs), reversible inhibitors of monoamine oxidase A, benzodiazepines, buspirone, beta blocker and gabapentin. Because of the wide variation in application of mind design, it is difficult to make specific therapeutic recommendations.

In general, treated patients were more likely to answer than patients who received placebo. The relative risk of nonresponse for treated patients was 063 (95 percent confidence interval, 055 to 072) Average symptom scores were better in patients who took SSRIs and MAOIs. However, funnel-plot analysis of treatment rejoinder suggests possible publication bias (i.e., small studies finding little or no benefit may not have been published).

This review supports the view that medications, especially SSRIs, are beneficial for pickeded patients with social phobia, at least in the short bourn (1,2)

CLARISSA KRIPKE, MD Stein DJ et al. Pharmacotherapy for social phobia. Cochrane Database Syst Rev 2004;(4):CD001206

REFERENCES

(1) Van Ameringen M Allgulander C Bandelow B Greist JH Hollander E Montgomery SA, et al. WCA recom-mendations for the long-term treatment of social phobia. CN Spectr 2003;8(8 suppl 1):40-52

(2) Ballenger JC Davidson JR Lecrubier Y Nutt DJ Bobes J Beidel DC et al. Consensus statement upon social anxiety disorder from the International Consensus form into groups on Depression and Anxiety. J Clin Psychiatry 1998;59(suppl 17):54-60

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