Update on the efficacy of pharmacotherapy for social anxiety disorder: a meta-analysis

Abstract

Introduction: Social anxiety disorder (SAD) is a common mental health problem that tends to be chronic in nature; fortunately, effective pharmacotherapy options exist. The current study provides an updated meta-analytic review of their efficacy and potential guidelines for their application in SAD.Methods: A comprehensive search of the current literature yielded 39 randomized, pill placebo-controlled trials of pharmacotherapy for adults diagnosed with SAD. Data on potential moderators of treatment outcome were collected, as well as data necessary to calculate effect sizes using Hedges’s g.Results: The overall effect size of pharmacotherapy for SAD is small to medium (Hedges’s g = 0.39). The most effective pharmacotherapy type was phenelzine (Hedges’s g = 1.14), followed by paroxetine (Hedges’s g = 0.49), venlafaxine ER (Hedges’s g = 0.45) and moclobemide (Hedges’s g = 0.23).Conclusion: Effect sizes were not moderated by age, sex, length of treatment, diagnostic subtype initial severity, maximum potential dose, or publication year. It is concluded that pharmacotherapy is effective for treating SAD, but there is considerable variation and room for further improvement. Future directions may include pharmacological enhancement of psychological processes, such as d-cycloserine augmentation of exposure procedures.