RECENT ADVANCES IN THE PSYCHOPHARMACOLOGY OF SOCIAL PHOBIA

1. The last two decades have witnessed an upsurge in the interest in a nxiety disorders. Much research effort has been dedicated to panic dis order and obsessive compulsive disorder. However, it is only very rece ntly that we have begun to understand some of the basic principles abo ut the psychopharmacology of social phobia. 2. Drug classes sofar stud ied include beta-blockers, nonselective and irreversible MAO-inhibitor s (MAOI's) and benzodiazepines. 3. Beta blockers appear to be of use i n specific social phobias, like public speaking. There is considerable evidence suggesting that MAOI's are effective in reducing both social anxiety as well as social avoidance. A disadvantage of the convention al irreversibel MAOI's is their risk for hypertensive crises when comb ined with dietary tyramine. So far only a small number of studies with selective MAOI-A inhibitors such as moclobemide and brofaromine have been conducted in social phobia, and the results indicate that both co mpounds are effective. 4. Drugs exerting selective and specific action s on certain compounds of e.g. the serotonergic system can now be stud ied and it is hoped that the role of 5-HT and other neuronal systems i n social phobia can be elucidated. 5. In order to gain more informatio n about selective serotonergic drugs the first double blind placebo co ntrolled study with fluvoxamine in social phobia is here reported. Pre liminary results indicate a reduction of social anxiety. 6. Finally th e role of peptides in the treatment of social phobia is critically rev iewed. The MSH/ACTH analog Org 2766 was investigated in patients suffe ring from social phobia. No anxiolytic effects of this peptide could b e observed.