MEDICATION THERAPY FOR SOCIAL PHOBIA

Social phobia, though the third most common psychiatric disorder in th e United States. has received little systematic attention until recent ly. Chronic and disabling symptoms usually precede other disorders in individuals with comorbidity, including alcohol abuse. Though about 80 % of individuals do not seek treatment. controlled trials have demonst rated efficacy for several medications. of which phenelzine (an irreve rsible monoamine oxidase inhibitor [MAOI]) is the best studied. The be nzodiazepines, clonazepam and alprazolam, also hold promise. New rever sible MAOIs such as moclobemide and brofaromine are under investigatio n; fluoxetine and other serotonin selective reuptake inhibitors need f urther controlled study. The benefits of group cognitive-behavioral th erapy also appear substantial. Issues for future investigation include long-term outcome. differential therapeutics, diagnostic subtyping, a nd combination treatments.