Basic Principles

The causes of social phobia and its treatment are similar to those of agoraphobia and simple phobia. Medications for this and

other phobic disorders have been useful in two contexts. First, the minor tranquilizers or anxiolytics are excellent means of

treating anxiety symptoms. However, they do not appear to block the actual process of panic attacks. Second, certain of the

tricyclic antidepressants have been used in some patients, often in doses well below those used for the Affective Disorders.

Considerable success in controlling panic attacks, with and without agoraphobia, has been reported in recent years through the

use of tricyclic antidepressants, especially imipramine (Tofranil), and monoamine oxidase inhibitors (MAOI's), such as phenelzine

(Nardil). The dramatic reduction in panic attacks that follows such medication is the central factor in recovery from agoraphobic

disorders. Sometimes the mere control of the panic is sufficient to allow patients to resume their customary activities. If

anticipatory anxiety persists despite the disappearance of the acute panic attacks, benzodiazepines or behavioral desensitization

or both are required to combat this more chronic form of anxiety. In addition, insight psychotherapy should be considered for

those patients who fulfill the criteria for this form of treatment; with the acute, disabling symptoms under pharmacological control,

such patients may be helped to resolve the psychological conflicts that frequently play a significant role in producing the surface

symptoms.

Antidepressant Drugs

Imipramine will block some panic attacks and clomipramine is a promising drug; however, the latter appears of more use in

Obsessive Compulsive Disorder and both have significant side effects. The MAO inhibitors are helpful for some patients.

Antianxiety Drugs

The minor tranquilizers have a particularly important place in the treatment of the phobic disorders. Chlordiazepoxide (Librium)

and diazepam (Valium) are both effective aids to the patient in his struggle with the phobic situation if they are taken in sufficient

doses to produce a relaxation of tension and musculature.

 

All Rights Reserved 2008