Pharmacotherapy for Social Anxiety Disorder and Specific Phobia

This chapter examines how, over the past two decades, there has been a rapid emergence of pharmacological treatment options for patients with generalized social anxiety disorder (GSAD). Results of treatment and neuroimaging studies suggest the involvement of serotonin, gamma-amino-butyric acid (GABA)/glutamate, and dopamine in GSAD. The literature clearly supports the use of SSRIs and the SNRI venlafaxine ER as first-line pharmacological agents in the treatment of GSAD; however, there is a paucity of data for patients who obtain a partial or nonresponse to first-line treatments as well as strategies to move GSAD individuals from response to remission. Exposure-based treatments are considered to be the gold standard treatment for specific phobias. There is a small literature on the use of pharmacological agents in specific phobias that does not support their use as the primary treatment modality.