scholarly journals Escitalopram in the treatment of social anxiety disorder

2005 ◽  
Vol 186 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Siegfried Kasper ◽  
Dan J. Stein ◽  
Henrik Loft ◽  
Rico Nil
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Primary Outcome Measure ◽  
Double Blind ◽  
Good Tolerability ◽  
Liebowitz Social Anxiety Scale ◽  
Social Components ◽  
To Receive

BackgroundSelective serotonin reuptake inhibitors are effective in the treatment of social anxiety disorder and are currently regarded as the pharmacotherapy of choice.AimsTo investigate the efficacy and tolerability of escitalopram in the treatment of generalised social anxiety disorder.MethodPatients with generalised social anxiety disorder were randomised to receive placebo (n=177) or 10–20 mg escitalopram (n=181) in a 12-week, double-blind trial. The primary outcome measure was the mean change from baseline to last assessment in the Liebowitz Social Anxiety Scale (LSAS) total score.ResultsThe study showed a statistically superior therapeutic effect for escitalopram compared with placebo on the LSAS total score (P=0.005). There were significantly more responders to treatment for escitalopram than for placebo (54% v. 39%; P < 0.0 1). The clinical relevance of these findings was supported by significant reduction in the work and social components of the Sheehan Disability Scale and by the good tolerability of escitalopram treatment.ConclusionsEscitalopram was efficacious and well tolerated in the treatment of generalised social anxiety disorder.

Pharmacological Treatments for Panic Disorder, Generalized Anxiety Disorder, Specific Phobia, and Social Anxiety Disorder

2015 ◽  
Author(s):  
Ryan J. Kimmel ◽  
Peter P. Roy-Byrne ◽  
Deborah S. Cowley
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Specific Phobia ◽  
Generalized Anxiety ◽  
Pharmacological Treatments ◽  
First Line

Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for panic disorder based on their low rate of side effects, lack of dietary restrictions, and absence of tolerance. SSRIs and venlafaxine are attractive first-line treatments for social anxiety disorder. Pharmacological treatments of choice for generalized anxiety disorder are buspirone and antidepressants, including SSRIs and venlafaxine. Benzodiazepines, although effective for all these disorders, lack efficacy for comorbid depression and carry the risk of physiological dependence and withdrawal symptoms. Their greatest utility seems to be as an initial or adjunctive medication for patients with disabling symptoms requiring rapid relief and for those unable to tolerate other medications. Chronic treatment with benzodiazepines is generally safe and effective but should probably be reserved for patients nonresponsive or intolerant to other agents. Larger trials are necessary to determine whether pharmacological agents might be useful as monotherapies, or adjuncts to exposure psychotherapy, for specific phobia.

Integrating Neurobiology and Psychopathology into Evidence-Based Treatment of Social Anxiety Disorder

CNS Spectrums ◽  
2005 ◽  
Vol 10 (S13) ◽  
pp. 1-2 ◽  
Author(s):  
Michael R. Liebowitz ◽  
Philip T. Ninan ◽  
Franklin R. Schneier ◽  
Carlos Blanco ◽  
David L. Ginsberg ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Strategies ◽  
Psychosocial Treatment ◽  
Development Theory ◽  
Future Research ◽  
Life Issues ◽  
Neuroreceptor Imaging

AbstractSocial anxiety disorder (SAD) is a common, chronic psychiatric disorder characterized by a persistent fear of social or performance situations in which embarrassment can occur. This disorder typically appears during the mid-adolescent years and is unremitting throughout life if not properly treated. SAD presents as two subtypes: the more common and debilitating generalized form, and the nongeneralized form, which consists predominantly of performance anxiety. The majority of patients with SAD have comorbid mental disorders, including mood, anxiety, and substance abuse. No single development theory has been proposed to account for the origins of SAD, although current understanding of the etiology of SAD posits an interaction between psychological and biological factors. Risk factors include environmental and parenting influences and dysfunctional cognitive and conditioning events in early childhood. The neurobiology of SAD appears to involve neurochemical dysfunction, as evidenced by studies of neuroreceptor imaging, neuroendocrine function, and profiles of response to specific medications. Clinical trials have demonstrated that benzodiazepines and antidepressants are effective in the treatment of SAD. The selective serotonin reuptake inhibitors are emerging as the first-line treatment for SAD, based on their proven safety, tolerability, and efficacy. Goals for ongoing future research include development of approaches to achieve remission, to convert nonresponders and partial responders to full responders, and to prevent relapse and maintain long-term efficacy.This monograph explores the epidemiology, clinical presentation, and differential diagnosis of SAD, with a focus on neural circuitry of social relationships and neurochemical dysfunction. The prevalence, rates of recognition and treatment, patterns of comorbidity, quality-of-life issues, and natural history of SAD are discussed as well as pharmacologic and psychosocial treatment strategies for SAD.

scholarly journals A Multicenter, Randomized, Double-blind, Placebo-Controlled Trial ofParoxetine in Children and Adolescents With Social Anxiety Disorder

2004 ◽  
Vol 61 (11) ◽  
pp. 1153 ◽  
Author(s):  
Karen Dineen Wagner ◽  
Ray Berard ◽  
Murray B. Stein ◽  
Erica Wetherhold ◽  
David J. Carpenter ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Children And Adolescents ◽  
Social Anxiety Disorder ◽  
Controlled Trial ◽  
Double Blind ◽  
Double Blind Placebo

Protein-source tryptophan as an efficacious treatment for social anxiety disorder: a pilot studyThis article is one of a selection of papers published in this special issue (part 1 of 2) on the Safety and Efficacy of Natural Health Products.

2007 ◽  
Vol 85 (9) ◽  
pp. 928-932 ◽  
Author(s):  
Craig Hudson ◽  
Susan Hudson ◽  
Joan MacKenzie
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Phobia ◽  
Social Anxiety Disorder ◽  
Objective Measure ◽  
Serum Levels ◽  
Protein Source ◽  
Intact Protein ◽  
Natural Health Products ◽  
Double Blind

Until recently, intact protein that is rich in tryptophan was not seen as an alternative to pharmaceutical-grade tryptophan because protein also contains large neutral amino acids (LNAAs) that compete for transport sites across the blood–brain barrier. Recent evidence indicates that when deoiled gourd seed (a rich source of tryptophan with approximately 22 mg/g protein) is combined with glucose (a carbohydrate that reduces serum levels of competing LNAAs) a clinical effect similar to that of pharmaceutical-grade tryptophan is achieved. Objective and subjective measures of anxiety in those suffering from social phobia (also known as social anxiety disorder) were employed to measure changes in anxiety in response to a stimulus as part of a double-blind, placebo-controlled, crossover study with a wash-out period of 1 week between study sessions. Subjects were randomly assigned to start with either (i) protein-source tryptophan (deoiled gourd seed) in combination with carbohydrate or (ii) carbohydrate alone. One week after the initial session, subjects returned for a follow-up session and received the opposite treatment of that received at the first session. All 7 subjects who began the study completed the 2-week protocol. Protein-source tryptophan with carbohydrate, but not carbohydrate alone, resulted in significant improvement on an objective measure of anxiety. Protein-source tryptophan combined with a high glycemic carbohydrate is a potential anxiolytic to those suffering from social phobia.

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