Cited by 99Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major DepressionSchizophrenia research and treatment

The evidence-based pharmacotherapy of social anxiety disorder

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Blanco, Carlos, Bragdon, Laura B., Schneier, Franklin R., Liebowitz, Michael R.·2013·International Journal of Neuropsychopharmacology

Abstract

Social anxiety disorder (SAD) is a highly prevalent and often disabling disorder. This paper reviews the pharmacological treatment of SAD based on published placebo-controlled studies and published meta-analyses. It addresses three specific questions: What is the first-line pharmacological treatment of SAD? How long should treatment last? What should be the management of treatment-resistant cases? Based on their efficacy for SAD and common co-morbid disorders, tolerability and safety, selective serotonin reuptake inhibitors (SSRIs) and venlafaxine should be considered the first-line treatment for most patients. Less information is available regarding the optimal length of treatment, although individuals who discontinue treatment after 12–20 wk appear more likely to relapse than those who continue on medication. Even less empirical evidence is available to support strategies for treatment-resistant cases. Clinical experience suggests that SSRI non-responders may benefit from augmentation with benzodiazepines or gabapentin or from switching to monoamine oxidase inhibitors, reversible inhibitors of monoamine oxidase A, benzodiazepines or gabapentin. Cognitive-behavioural is a well-established alternative first line therapy that may also be a helpful adjunct in non-responders to pharmacological treatment of SAD.

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  1. Bridge JA, Iyengar S, Salary CB, Barbe RP, et al. (2007). Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment. Journal of the American Medical Association 297, 1683-1696.

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Authors
Blanco, C., Bragdon, L. B., Schneier, F. R., & Liebowitz, M. R.
Affiliations
New York State Psychiatric Institute (US)
Corresponding author
Blanco, Carlos
Venue
International Journal of Neuropsychopharmacology
Published
2013-02-01
Volume
16
Issue
1
Pages
235-249
ISSN
  • 1461-1457 (ISSN-L)
  • 1469-5111
OpenAlex
W2135684036
Cited by
99
References
117
Citations by year
2026: 5 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 8 · 2021: 11 · 2020: 12 · 2019: 7 · 2018: 6 · 2017: 10 · 2016: 8 · 2015: 9 · 2014: 6 · 2013: 5
FWCI
0.94
Type
journal article
Language
en
Open access
Locations
  • The International Journal of Neuropsychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Institute on Drug Abuse (R01DA020783, DA019606, DA020783, DA023200, R01DA019606, K02DA023200)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
social anxiety disorder, pharmacotherapy, selective serotonin reuptake inhibitors, venlafaxine, first-line therapy, treatment duration, relapse, treatment-resistant anxiety, augmentation therapy, benzodiazepines, gabapentin, monoamine oxidase inhibitors, cognitive behavioral therapy, safety and tolerability
MeSH terms
Animals, Antidepressive Agents, Anxiety Disorders, Humans, Monoamine Oxidase Inhibitors, Phobic Disorders, Selective Serotonin Reuptake Inhibitors, Controlled Clinical Trials as Topic, Evidence-Based Medicine

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