Paroxetine in Social Phobia

Background: Several open trials suggest the efficacy of the selective serotonin reuptake inhibitors (SSRIs) in social phobia. This study attempted to assess the efficacy of paroxetine, a new SSRI, in the treatment of social phobia.

Method: Paroxetine was administered to 18 patients who had a primary DSM-III-R diagnosis of social phobia, generalized type (diagnosed by using the Structured Clinical Interview for DSMIII- R), in a 12-week open, clinical trial. Treatment began at 10 mg of paroxetine daily and was increased according to clinical response and side effects. Patients completed self-report measures at baseline and at Weeks 4, 8, and 12. These measures included the Fear of Negative Evaluation Scale, the Social Avoidance and Distress Scale, the Social Anxiety Thoughts Questionnaire, the Fear Questionnaire, the State-Trait Anxiety Inventory, the Beck Depression Inventory, the Social Adjustment Scale Self-Report, and the Sheehan Disability Scale. Clinicians completed the Liebowitz Panic and Social Phobic Disorders Rating Form.

Results: All 18 patients completed the 12-week trial. Fifteen (83.3%) were considered responders (moderate or marked improvement), and 3 (16.7%) were considered to be nonresponders (minimal improvement or no change of their symptoms). All measures of social anxiety, social phobic avoidance, depression, and social functioning showed a statistically significant change at endpoint.

Conclusion: These findings support a role for paroxetine in the treatment of social phobia, generalized type. Controlled studies will be required to further investigate this preliminary finding as well as to compare paroxetine with other pharmacologic treatments of social phobia.