Ja. Denboer et al., RECENT DEVELOPMENTS IN THE PSYCHOPHARMACOLOGY OF SOCIAL PHOBIA, European archives of psychiatry and clinical neuroscience, 244(6), 1995, pp. 309-316
The past 2 decades have witnessed an upsurge in the interest in anxiet
y disorders. Much research effort has been dedicated to panic disorder
and obsessive - compulsive disorder. However, it is only very recentl
y that we have begun to understand some of the basic principles about
the psychopharmacology of social phobia. Drug classes thus far studied
include beta-blockers, nonselective and irreversible monoamine oxidas
e inhibitors (MAOIs), and benzodiazepines. Beta blockers appear to be
of use in specific social phobias, such as public speaking, whereas th
ey are of little use in generalized social phobia. There is considerab
le evidence suggesting that MAOIs are effective in reducing both socia
l anxiety as well as social avoidance in generalized social phobia. A
disadvantage of the conventional irreversible MAOIs is their risk for
hypertensive crises when combined with dietary tyramine. Thus far only
a small number of studies with selective MAO-A inhibitors, such as mo
clobemide and brofaromine, have been conducted in social phobia, and t
he results indicate that both compounds are effective. Drugs exerting
selective and specific actions on certain components of, for example,
the serotonergic system, can now be studied, and it is hoped that the
role of 5-hydroxytryptamine) and other neuronal systems in social phob
ia can be elucidated. In order to gain more information about selectiv
e serotonergic drugs, the first double-blind placebo-controlled study
with fluvoxamine was recently published. Preliminary results indicate
a reduction in social anxiety after a prolonged treatment period. Fina
lly, the role of peptides in the treatment of social phobia is critica
lly reviewed. The MSH/ACTH analog Org 2766 was investigated in patient
s suffering from social phobia. No anxiolytic effects of this peptide
were observed.