Columbia University College of Physicians and Surgeons, and Research Psychiatrist, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
Expert Opin Pharmacother. 2011 Mar;12(4):615-25. doi: 10.1517/14656566.2011.534983. Epub 2011 Jan 18.
Social anxiety disorder (SAD) is one of the most common psychiatric disorders, with a lifetime prevalence of 5-12%. Fears of scrutiny and embarrassment in social and public situations are accompanied by anxiety symptoms, avoidance behavior, and impairment in social and work functioning. Several classes of medication, as well as cognitive-behavioral therapies, have evidence for efficacy in the treatment of SAD, but only a minority of individuals with the disorder receives treatment.
This review focuses on the evidence-based treatment of SAD with medications including serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, monoamine oxidase inhibitors, other antidepressants, benzodiazepines, alpha-delta calcium-channel agents, and beta-adrenergic blockers. It discusses clinical considerations in the selection and monitoring of treatments, including issues of safety, duration of treatment, comorbidity, and integration of medication with psychotherapeutic treatment. For this review, a PubMed literature search was conducted during July, 2010.
Medications in several classes have been demonstrated efficacious in the treatment of SAD. Treatment selection and implementation require attention to clinical diagnosis, patient education, and appropriate monitoring.
社交焦虑障碍（SAD）是最常见的精神障碍之一，终身患病率为 5-12%。在社交和公共场合中，对他人的审视和尴尬的恐惧伴随着焦虑症状、回避行为以及社交和工作功能受损。有几类药物以及认知行为疗法都被证明对 SAD 的治疗有效，但只有少数患有该障碍的人接受治疗。
本综述重点介绍了药物治疗 SAD 的循证方法，包括选择性 5-羟色胺再摄取抑制剂、5-羟色胺-去甲肾上腺素再摄取抑制剂、单胺氧化酶抑制剂、其他抗抑郁药、苯二氮䓬类药物、α-δ 钙通道剂和β-肾上腺素能阻滞剂。它讨论了治疗选择和监测中的临床注意事项，包括安全性、治疗持续时间、共病和药物治疗与心理治疗的整合等问题。为了进行这次综述，我们在 2010 年 7 月进行了一次 PubMed 文献检索。
几类药物已被证明对 SAD 的治疗有效。治疗的选择和实施需要注意临床诊断、患者教育和适当的监测。
