The novel anxiolytic agent buspirone has been shown to be effective in
generalized anxiety disorder, but its utility in phobic disorders is
less clear. We examined its efficacy in social phobia in a 12-week ope
n trial. Twenty-one patients who met DSM-III-R criteria for social pho
bia and who did not respond to 1 week of single-blind placebo were tre
ated with buspirone, and 17 completed a minimum of 2 weeks of treatmen
t. Twelve of these 17 patients met criteria for the generalized subtyp
e of social phobia. At week 12, 8 (47%) of the 17 patients were rated
much to very much improved in social phobia symptoms on the Clinical G
lobal Impression Scale. Of the 12 patients who were able to tolerate a
dose of 45 mg/day or more, 9 (67%) were at least much improved. Signi
ficant improvement was noted on measures of social anxiety and avoidan
ce of social situations. Ratings of generalized anxiety and depression
, which were low at baseline, did not change significantly during trea
tment. The results suggest that buspirone may have modest efficacy in
the treatment of social phobia, but confirmation in a placebo-controll
ed trial is required.