Effect of quetiapine vs. placebo on response to two virtual public speaking exposures in individuals with social phobia

Objective: Clinical practice and open-label studies suggest that quetiapine (an atypical anti-psychotic) might improve symptoms for individuals with social anxiety disorder (SAD). The purpose of this study was to provide a rigorous test of the acute impact of a single dose of quetiapine (25 mg) on SAD symptoms. Method: Individuals with SAD (N = 20) were exposed to a 4-min virtual reality (VR) public speaking challenge after having received quetiapine or placebo (double-blind) 1 h earlier. A parallel VR challenge occurred 1 week later using a counter-balanced cross-over (within subject) design for the medication-placebo order between the two sessions. Result: There was no significant drug effect for quetiapine on the primary outcome measures. However, quetiapine was associated with significantly elevated heart rate and sleepiness compared with placebo. Conclusion: Study findings suggest that a single dose of 25 mg quetiapine is not effective in alleviating SAD symptoms in individuals with fears of public speaking. (C) 2008 Elsevier Ltd. All rights reserved.