RECENT DEVELOPMENTS IN THE PSYCHOPHARMACOLOGY OF SOCIAL PHOBIA

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.