Social phobia: a pharmacologic treatment overview.

Generalized and specific social phobias are common, chronic, and potentially debilitating conditions. In recent years, there have been major advances in the pharmacotherapy of social phobia; efficacy has become better established for a diverse group of medications. Controlled studies have shown substantial benefit from monamine oxidase inhibitors, both irreversible (phenelzine) and reversible (brofaromine and moclobemide). The serotonin selective reuptake inhibitor antidepressants have shown promise in case reports, uncontrolled studies, and double-blind trials (fluvoxamine and sertraline). The benzodiazepines have been extensively used to treat social phobia, although only recently has a controlled, double-blind study confirmed efficacy (clonazepam). The beta-adrenergic receptor blockers have been widely used on an as needed basis to treat specific social phobia (i.e., performance anxiety), although their value in generalized social phobia has not been convincing. Finally, pharmacologic approaches to social phobia must take into consideration the common coexistence of other psychiatric conditions.