Jefferson J W
Dean Foundation for Health, Resarch and Education, Madison, Wis. 53717-1914, USA.
J Clin Psychiatry. 1995;56 Suppl 5:18-24.
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.
广泛性社交恐惧症和特定性社交恐惧症很常见、病程长，且可能使人衰弱。近年来，社交恐惧症的药物治疗取得了重大进展；多种药物的疗效已得到更好的确立。对照研究表明，单胺氧化酶抑制剂（包括不可逆的苯乙肼和可逆的溴法罗明及吗氯贝胺）有显著疗效。5-羟色胺选择性再摄取抑制剂类抗抑郁药在病例报告、非对照研究和双盲试验（氟伏沙明和舍曲林）中已显示出前景。苯二氮䓬类药物已被广泛用于治疗社交恐惧症，不过直到最近才有一项对照双盲研究证实其疗效（氯硝西泮）。β-肾上腺素能受体阻滞剂已被广泛按需用于治疗特定性社交恐惧症（即表演焦虑症），尽管其在广泛性社交恐惧症中的价值尚未令人信服。最后，社交恐惧症的药物治疗方法必须考虑到其他精神疾病的常见共病情况。
