Pollack M H, Gould R A
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
Int Clin Psychopharmacol. 1996 Jun;11 Suppl 3:71-5. doi: 10.1097/00004850-199606003-00012.
Social phobia has been recognized as a discrete diagnostic condition only relatively recently. Epidemiological studies have shown that social phobia is associated with significant impairment and an increasing body of evidence has now indicated that pharmacological treatment is effective. Placebo-controlled studies have demonstrated the efficacy of the monoamine oxidase inhibitor phenelzine. A reversible inhibitor of monoamine oxidase A, moclobemide, is better tolerated and safer than the irreversible monoamine oxidase inhibitors and placebo-controlled studies have also demonstrated efficacy for this compound; moreover, positive results from a small study of brofaromine also support the efficacy of this class of compounds. It has been reported that a high-potency benzodiazepine, clonazepam, is effective but there is little placebo-controlled evidence to support the use of other benzodiazepines. Selective serotonin reuptake inhibitors are also being tested in social phobia with encouraging results. More studies are now needed on the long-term treatment of social phobia.
社交恐惧症直到最近才被公认为一种独立的诊断病症。流行病学研究表明，社交恐惧症会导致严重的功能损害，并且越来越多的证据表明药物治疗是有效的。安慰剂对照研究已经证明单胺氧化酶抑制剂苯乙肼具有疗效。一种单胺氧化酶A的可逆抑制剂吗氯贝胺，比不可逆的单胺氧化酶抑制剂耐受性更好且更安全，安慰剂对照研究也已证明该化合物具有疗效；此外，一项关于溴法罗明的小型研究的阳性结果也支持这类化合物的疗效。据报道，一种高效苯二氮䓬类药物氯硝西泮是有效的，但几乎没有安慰剂对照证据支持使用其他苯二氮䓬类药物。选择性5-羟色胺再摄取抑制剂也正在社交恐惧症中进行测试，结果令人鼓舞。现在需要更多关于社交恐惧症长期治疗的研究。
