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Recent developments in the psychopharmacology of social phobia

Published online by Cambridge University Press:  18 September 2015

Den J.A. Boer ,
I.M. Van Vliet  and
H.G.M. Westenberg
Den J.A. Boer*
Affiliation:
Biologische Psychiatrie, Academisch Ziekenhuis Utrecht
I.M. Van Vliet
Affiliation:
Biologische Psychiatrie, Academisch Ziekenhuis Utrecht
H.G.M. Westenberg
Affiliation:
Biologische Psychiatrie, Academisch Ziekenhuis Utrecht
*
Universitair Hoofddocent Klinische en Biologische Psychiatrie, Academisch ziekenhuis Utrecht, Afdeling Biologische Psychiatrie, Postbus 85500, 3508 GA Utrecht
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Summary

The last two decades have witnessed an upsurge in the interest in anxiety disorders. Much research effort has been dedicated to panic disorder and obsessive compulsive disorder. However, it is only very recently that we have begun to understand some of the basic principles about the psychopharmacology of social phobia. Drug classes so far studied include beta-blockers, non-selective and irreversible MAO-inhibitors (MAOI's) and benzodiazepinen. Beta-blockers appear to be of use in specific social phobias, like public speaking. There is considerable evidence suggesting that MAOI's are effective in reducing both social anxiety as well as social avoidance. A disadvantage of the conventional irreversible MAOI's is their risk for hypertensive crises when combined with dietary tyramine.

So far only a small number of studies with selective MAOI-A inhibitors such as moclobemide and brofaromine have been conducted in social phobia, and the results indicate that both compounds are effective.

Drugs exerting selective and specific actions on certain components of e.g. the serotonergic system can now be studied and it is hoped that the role of serotonin and other neuronal systems in social phobia can be elucidated.

In order to gain more information about selective serotonergic drugs the first double blind placebo-controlled study with fluvoxamine in social phobia is here reported. Preliminary results indicate a reduction of social anxiety.

Finally the role of peptides in the treatment of social phobia is critically reviewed. The MSH/ACTH analog Org 2766 was investigated in patients suffering from social phobia. No anxiolytic effects of this peptide could be observed.

Keywords

social phobiabenzodiazepinesbeta-blocking agentsbrofarominemoclobemidefluvoxamineOrg 2766sociale fobiebenzodiazepines bêta-blokkersbrofarominemoclobemidefluvoxamineOrg2766
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 5 , Issue 4 , December 1993 , pp. 76 - 82
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1993

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References

Literatuur

1Den Boer, JA, Westenberg, HGM. Serotonin function in panic disorders: a double blind placebo controlled study with fluvoxamine and ritanserin. Psychopharmacol 1990;102:85–94.CrossRefGoogle ScholarPubMed
2Den Boer, JA, Westenberg, HGM. Do panic attacks reflect an abnormality in serotonin receptor subtypes? Hum Psychopharm 1991;6:25–30.CrossRefGoogle Scholar
3Burton, R. The anatomy of melancholy 1621. Reprint: London, Toronto: JM Dent & Sons Ltd, 1977:261.Google Scholar
4Solyom, L, Ledwidge, B, Solyom, C. Delineating social phobia. Br J Psychiat 1986;149:464-70.CrossRefGoogle ScholarPubMed
5Reich, J, Yates, W. A pilot study of treatment of social phobia with Alprazolam. Am J Psychiat 1988;145:5;590-4.Google ScholarPubMed
6Lydiard, RB, Laraia, MT, Howell, EF, Ballenger, JC. Alprazolam in the treatment of social phobia. J din Psychiat 1988;49:I;17-9.Google ScholarPubMed
7Davidson, JRT, Ford, SM, Smith, RD, Potts, NLS. Long-term treatment of social phobia with Clonazepam. J clin Psychiat 1991;52:(11, suppl)16–20.Google ScholarPubMed
8Liebowitz, MR, Schneier, FR, Hollander, E, et al.Treatment of social phobia with drugs other than benzodiazepines. J clin Psychiat 1991;52(11, suppl):10-5.Google ScholarPubMed
9Liebowitz, MR, Schneier, F, Campeas, R, et al.Phenelzine vs atenolol in social phobia. Arch gen Psychiat 1992;49:290–300.CrossRefGoogle ScholarPubMed
10Gelernter, CS, Uhde, TW, Cimbolic, P, et al.Cognitive-behavioral and pharmacological treatments of social phobia. Arch gen Psychiat 1991;48:938-45.CrossRefGoogle ScholarPubMed
11Versiani, M, Nardi, AE, Mindim, FD, Alves, AB, Liebowitz, MR, Amrein, R. Pharmacotherapy of social phobia. A controlled study with moclobemide and phenelzine. Br J Psychiat 1992;161:353-60.CrossRefGoogle ScholarPubMed
12Van Vliet, IM, Den Boer, JA, Westenberg, HGM. Psychopharmaco-logical treatment of social phobia: clinical and biochemical effects of brofaromie, a selective MAO-A inhibitor. Eur Neuropsychop-harmacol 1992;2:21-9.CrossRefGoogle Scholar
13Den Boer, JA, Westenberg, HGM. Effects of a serotonin and noradrenaline uptake inhibitor in panic disorder: a double blind comparative study with fluvoxamine and maprotiline. Int clin Psychopharmacol 1988;3:59–74.CrossRefGoogle ScholarPubMed
14Pecknold, JC, McClure, DJ, Appeltauer, L, Allan, T, Wrzesinski, L. Does tryptophan potentiate clomipramine in the treatment of agoraphobic and social phobia patients? Br J Psychiat 1092;140:484-90.CrossRefGoogle Scholar
15Sternbach, H. Fluoxetine treatment of social phobia. J clin Psychopharmacol 1990;10:230.CrossRefGoogle ScholarPubMed
16Black, B, Uhde, TW, Tancer, ME. Fluoxetine for the treatment of social phobia. J clin Psychopharmacol 1992;4:293-5.Google Scholar
17Schneier, F, Campeas, R, Fallon, B, et al.Buspirone in social phobia (abstract). Presentation at the 17th Congress of Collegium Internationale Neuro-Psychopharmacologicum. Kyoto; Japan, 1991.Google Scholar
18Munjack, DJ, Bruns, J, Baltazar, PL, et al.A pilot study of buspirone in the treatment of social phobia. J Anx Disord 1991;5:87–98.CrossRefGoogle Scholar
19File S.E. Effects of ACTH 4-10 in the social interaction test of anxiety. Brain Res 1979;171:157-60.CrossRefGoogle Scholar
20File S.E. The use of social interaction as a method for detecting anxiolytic activity of chlordiazepoxide-like drugs. J Neurosci Meth 1980;2:219-38.CrossRefGoogle Scholar
21File, S, Velluci, SV. Studies on the role of ACTH and 5-HT in anxiety, using an animal model. J Pharm Pharmacol 1978;30:105-10.CrossRefGoogle ScholarPubMed
22File SE. Contrasting effects of Org 2766 and alpha-MSH on social and exloratory behavior in the rat. Peptides 1981;2:255-60.CrossRefGoogle Scholar
23Ferris, SH, Reisberg, B, Gershon, S. Neuropeptide modulation of cognition and memory in humans. Poon, L. (Ed) Aging in the 1980's: Selected contemporary issues in the psychology of aging. Washington DC: Am Psychol Assoc 1981:212-20.Google Scholar
24Den Boer, JA, HGM Westenberg, Hde Vries, . The MSH/ACTH analog ORG 2766 in anxiety disorders. Peptides 1992;13:109-12.CrossRefGoogle ScholarPubMed
25Van Praag, HM, Kahn, RJ, Asnis, GM, Wetzler, S, Brown, SL, Bleich, A, Korn, ML. Denosologisation of biological psychiatry or the specificity of 5-HT disturbances in psychiatric disorders. J affect Disord 1987;13:1–8.CrossRefGoogle ScholarPubMed
26Van Praag, HM. About the centrality of mood lowering in mood disorders. Eur Neuropsychopharmacol 1992;2:393–404.CrossRefGoogle ScholarPubMed