Social phobia is a prevalent anxiety disorder with potentially signifi
cant dysfunction and a high rate of comorbid depression. Treatment wit
h an antidepressant is often indicated. Venlafaxine's dual activity at
both serotonin and norepinephrine transporters suggests that it might
be efficacious in treating social phobia, particularly in patients wh
o do not respond to selective serotonin reuptake inhibitors (SSRIs). T
his report describes an open-label trial of venlafaxine in 9 patients
with social phobia. Eight patients had previously been treated with an
SSRI and had either been unable to tolerate the medication or failed
to respond to it. Eight patients had a marked improvement on venlafaxi
ne. The results from this chart review suggest that venlafaxine may be
a valuable treatment for social phobia. Clearly, larger double-blind
placebo-controlled studies are needed. Patients with social phobia may
do better with a starting dose smaller than the one in the package in
sert.