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Social Anxiety Disorder

Current Treatment Recommendations

  • Therapy in Practice
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Abstract

Social anxiety disorder (SAD) is a prevalent and disabling disorder associated with significant co-morbidity. An increased awareness of SAD over the past two decades has given impetus to advances in the pharmacotherapeutic and psychotherapeutic treatment options for this disorder. On the basis of consistent data from randomised controlled trials, present consensus supports the use of SSRIs as the first-line treatment in generalised SAD, partly because of established short-and long-term efficacy in this disorder, evidence for safety and tolerability, and ability to treat co-morbid conditions. There is more recent evidence that venlafaxine XR (extended release) may also be considered a first-line treatment in SAD. Second-line treatments include MAOIs (e.g. phenelzine) and reversible inhibitors of monoamine oxidase A (e.g. moclobemide), while some benzodiazepines and antiepileptics (e.g. clonazepam and pregabalin) may also be useful. Over the past two decades, cognitive behavioural therapies for SAD have gained increasing empirical support. The optimal approach to the management of treatment-refractory SAD patients requires additional study.

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Acknowledgements

Dr Muller, Dr Seedat and Professor Stein are supported by the Medical Research Council (MRC) of South Africa. The authors have received research grants and/or consultancy honoraria from AstraZeneca, Eli Lilly, GlaxoSmithKline, Lundbeck, Orion, Pfizer, Pharmacia, Roche, Servier, Solvay, Sumitomo and Wyeth.

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  1. Department of Psychiatry, University of Stellenbosch, Tygerberg, Cape Town, South Africa

    Jacqueline E. Muller, Liezl Koen, Soraya Seedat & Dan J. Stein

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  1. Jacqueline E. Muller
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  2. Liezl Koen
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  3. Soraya Seedat
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  4. Dan J. Stein
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Correspondence to Jacqueline E. Muller.

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Muller, J.E., Koen, L., Seedat, S. et al. Social Anxiety Disorder. CNS Drugs 19, 377–391 (2005). https://doi.org/10.2165/00023210-200519050-00002

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