Abstract
In this chapter we review the psychopharmacological treatment of social anxiety disorder (SAD). We present a summary of the clinical trials of medication for SAD focusing mainly on published placebo-controlled studies and meta-analyses. Based on their efficacy for SAD and common co-occurring disorders, tolerability and safety, selective serotonin reuptake inhibitors (SSRIs) and venlafaxine should be considered the first-line pharmacological treatment for most patients. Less information is available regarding the optimal length of treatment or the management of treatment-resistant cases. Clinical experience and limited systematic data suggest that augmentation with benzodiazepines or gabapentin, or switching to monoamine oxidase inhibitors, benzodiazepines or gabapentin can be useful in treatment-resistant cases. Cognitive-behavioral treatment can also be a helpful adjunct or alternative in non-responders to pharmacological treatment of SAD.
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