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STUDY FINDS
ANOTHER OPTION FOR TREATING SOCIAL ANXIETY DISORDER
New York, NY (April 12, 2005)—Social phobia/social anxiety disorder is
the third most common psychiatric disorder after major depression and
alcohol dependence. Social phobia, and particularly generalized social
phobia, is an excessive and irrational fear of social situations. People
with generalized social phobia do not limit their fears to one or two
circumstances (a fear of public speaking, for example) but have difficulty
in a wide variety of interpersonal situations (striking up a conversation
with an acquaintance at a party or speaking up at a staff meeting). For
patients there was only one medication option for treatment, a selective
serotonin reuptake inhibitor (SSRI) like paroxetine or sertraline. Now,
a study published in the February issue of the Archives of General Psychiatry
indicates that venlafaxine extended release (ER) is just as effective
a treatment for generalized social phobia as paroxetine, the most commonly
prescribed treatment.
Venlafaxine ER is in a class of antidepressants called serotonin-norepinephrine
reuptake inhibitors (SNRI). It, therefore, acts upon not only the neurotransmitter
serotonin but norepineprhine as well, both of which are important in regulating
mood. In contrast, paroxetine or setraline acts solely on the neurotransmitter
serotonin.
The study, believed to be the first to compare these two types of medications,
looked at a total of 440 patients who had generalized social anxiety for
more than six months. Patients were chosen at random to receive venlafaxine
ER, paroxetine or placebo for 12 weeks. Upon completion of the study,
it was found that 58% of (133) patients on venlafaxine ER responded to
treatment compared to 62% of (136) patients on paroxetine.
“While SSRI’s are effective for treating some patients with social phobia,
some do not respond to treatment. For this group of patients, an SNRI
like venlafaxine ER may alleviate their symptoms and would, therefore,
be a welcome alternative for them as well as the treating psychiatrist,”
said Dr. Michael Liebowitz, the lead author and Director of the Anxiety
Disorders Clinic at the New York State Psychiatric Institute/Columbia
University Medical Center.
Though the issue of sexual side effects was not a priority in this study,
paroxetine is known to cause ejaculatory difficulty in men. This is a
troubling side effect and a big disincentive to would-be patients. “Venlafaxine
ER has been shown to be less likely to cause this sexual problem thereby
making it more attractive to doctors and patients. Given the fact that
many people with social phobia wait years before seeking treatment, when
they do finally get help it is important that they know they have options.
The fewer barriers to compliance, the better their outcome is likely to
be and the more improved their quality of life,” said Dr. Liebowitz.
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