Understanding Pharmacological Treatments for Social Anxiety Disorder

A review of “The Evidence-Based Pharmacotherapy of Social Anxiety Disorder”

THE MAIN POINT:

In a recent study, Blanco, Bragdon, Schneier, and Liebowitz (2013) reviewed the latest research on pharmacological treatment for Social Anxiety Disorder (SAD). The authors conclude that Selective Serotonin Reuptake Inhibitors (SSRIs) and venlafaxine should be considered the treatment of choice. In addition, the authors note that some recent evidence suggests that combining medication with CBT leads to a better treatment outcomes than either CBT alone or medication alone. Overall, the authors recommend that clinical professionals use this information to develop and coordinate evidence-based treatment.

THE DETAILS:

What were the goals of this study?

There were three main goals for this study:

  • To determine what treatment the best research support for the treatment of SAD and should be considered the “first-line” treatment.
  • To examine information about treatment length and its impact on treatment success.
  • To determine what other treatments have good research support.

How did the authors examine the study goals?

The authors searched databases for peer-reviewed articles that examined treatment for social anxiety disorder (also referred to as social phobia). Blanco et al. (2013) limited their search to studies that employed a randomized design and used a placebo/control group. They also focused on studies testing pharmacological treatments.

What were the main findings from this study?

There were three main findings:

  • The authors evaluated numerous studies and meta-analyses and the decided to make their recommendations for the best treatment based upon several factors: (a) the effect size of the treatment; (b) the potential for negative side effects; and (c) the potential for the treatment to concurrently treat comorbid diagnoses. Based upon these guidelines, the authors concluded that SSRIs are venaflaxine are the best treatments for SAD.
  • The authors note that few studies examine treatment length for SAD; however, they note that research suggests that the risk of symptom reoccurrence is higher when pharmacological treatment is discontinued within 12-20 weeks. Based on this information, the authors conclude that the recommended length for pharmacological treatment should be at least 3-6 months long.
  • The authors found that psychotherapy, particularly CBT, has been shown to be efficacious in the treatment of SAD. In addition, they note that some studies suggest that the combination of CBT and medication may be more efficacious than either treatment alone.

What are the clinical implications of this study?

The results of this review suggest new guidelines for the treatment of SAD. For prescribing physicians, this information may be integrated into their existing knowledgebase. For non-prescribing clinical professionals, this information may aid in making appropriate referrals and understanding the pharmacological treatment that their clients may be undergoing.

How can I learn more about this study?

If you would like to learn more about this study, please click the following link:

http://www.ncbi.nlm.nih.gov/pubmed/22436306

How can I learn more about CBT for SAD?

If you would like to learn more about CBT for SAD, you may consider purchasing the therapist guide for the treatment. If you are interested, please click the following link:

http://www.oup.com/us/companion.websites/0195189930/?view=usa

References

Blanco, C., Bragdon, L. B., Schneier, F. R., & Liebowitz, M. R. (2013). The evidence-based pharmacotherapy of social anxiety disorder. Int J Neuropsychopharmacol, 16(1), 235-249. doi: 10.1017/s1461145712000119

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