Patients with social anxiety disorder who are seen in clinical practice commonly have additional psychiatric comorbidity, including alcohol use disorders. The first line treatment for social anxiety disorder is selective-serotonin-reuptake-inhibitors (SSRIs), such as paroxetine. However, the efficacy of SSRIs has been determined with studies that excluded alcoholics.
Forty two subjects with social anxiety and a co-occurring alcohol use disorder participated in a 16-week, double-blind, placebo-controlled clinical trial to determine the efficacy of paroxetine for social anxiety in patients with co-occurring alcohol problems.
Paroxetine was superior to placebo in reducing social anxiety, as measured by the Liebowitz Social Anxiety Scale total and subscale scores and additional measures of social anxiety.
This study provides the first evidence-based recommendation for the use of an SSRI to treat social anxiety in this patient population.
Keywords: Social anxiety disorder; Dual-diagnosis; Comorbidity; SSRI
Sarah W. Book, Suzanne E. Thomas, Patrick K. Randall and Carrie L. Randall
Department of Psychiatry and Behavioral Sciences, Charleston Alcohol Research Center,
Medical University of South Carolina, Charleston, SC 29425, United States
Received 5 December 2006; revised 27 February 2007; accepted 6 March 2007. Available online 12 March 2007.