Search

Publisher Summary Pharmacotherapy is a reasonable option for most individuals with social anxiety disorder (SAD), given the degree of associated impairment and the efficacy of established medication treatments for the disorder. Pharmacological approaches to SAD have been shown to substantially reduce avoidance and psychological distress. Furthermore, both cognitive and physical symptoms of anxiety can interfere with optimal performance and ultimately lead to avoidance of feared situations; thus, medications that can directly decrease anxiety and physical symptoms typical of the disorder may help improve performance in social or professional situations. Finally, tendencies toward shyness and excessive concerns about social comparisons are likely to be strongly biologically based, given the early onset of behaviorally inhibited temperament, evidence of a significant genetic contribution from twin and family studies, and the biological salience of social hierarchies in the evolution of humans as a group-living species. These findings support the use of biologically based treatments. A number of medications have been studied for the treatment of SAD. Early reports suggested the potential value of MAOI, reversible inhibitors of MAO-A (RIMAs), and benzodiazepines. Most clinical trials have included predominantly or exclusively patients with the generalized type of SAD. This chapter presents a review of the research progress on pharmacotherapy for SAD over time.