Selective serotonin reuptake inhibitors in the treatment of social phobia: The emerging gold standard

Social phobia is the third most common psychiatric illness in the community. It is characterised by a marked and persistent fear of one or more social or performance situations in which the individual is exposed to unfamiliar people or to possible scrutiny by others. Social phobia is often associated with significant morbidity and functional impairment. Treatments for social phobia have started to be extensively evaluated over the past decade and there is now evidence for the effectiveness of cognitive behavioural therapy and pharmacotherapy. Controlled studies support the efficacy of nonselective monoamine oxidase inhibitors (MAOIs), reversible inhibitors of monoamine oxidase-A (RIMAs), high potency benzodiazepines and, most recently, selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs). This article reviews the open and placebo controlled trials of SSRIs in the treatment of social phobia. There is an accumulating body of evidence that supports the efficacy of SSRIs in the treatment of the disorder. Given the tolerability and efficacy of SSRIs in the treatment of social phobia, they are likely to become the new gold standard for the pharmacological treatment of this disorder.