Treatment of Social Phobia With Antidepressants

This article reviews evidence for the utility of antidepressant medications in the treatment of socialphobia. Monoamine oxidase inhibitors (MAOIs) were the first antidepressants shown to be effectivefor social phobia, but dietary restrictions and a relatively high rate of adverse effects often relegateMAOIs to use after other treatments have been found ineffective. Reversible inhibitors of monoamineoxidase (RIMAs) hold promise as safer alternatives to MAOIs, but RIMAs may be less effective andare currently unavailable in the United States. Selective serotonin reuptake inhibitors (SSRIs), ofwhich paroxetine has been the best studied in social phobia to date, have recently emerged as a firstlinetreatment for the generalized subtype of social phobia. The SSRIs are well tolerated and consistentlyhave been shown to be efficacious in controlled trials.