A double-blind
placebo-controlled trial of paroxetine in the management of social phobia
(social anxiety disorder) in South Africa
by
Stein DJ, Berk M, Els C, Emsley RA,
Gittelson L, Wilson D, Oakes R, Hunter B
Department of Psychiatry,
University of Stellenbosch,
Tygerberg, W Cape.
S Afr Med J 1999 Apr; 89(4):402-6
ABSTRACT
BACKGROUND: Social phobia, also known as social
anxiety disorder, is a highly prevalent disorder with significant morbidity.
Patients with social phobia frequently develop co-morbid psychiatric
disorders such as depression and substance abuse, and the disorder impacts
significantly on social and occupational functioning. It has been suggested
that the selective serotonin reuptake inhibitors (SSRIs) are useful in the
management of this disorder, but few controlled trials have been undertaken
in this regard. There are also few data on the pharmacotherapy of social
phobia in South Africa.
METHODS: A double-blind randomised
placebo-controlled multi-site flexible-dose trial of paroxetine was
undertaken over 12 weeks among patients with a primary diagnosis of social
phobia. Primary response measures were the Global Improvement item on the
Clinical Global Impression scale (CGI) and mean change from baseline in the
patient-rated Liebowitz Social Anxiety Scale (LSAS) total score.
Ninety-three patients participated at 9 South African sites; their data are
reported here.
RESULTS: There was a significant drug effect
on both the CGI Global Improvement score and the LSAS at 12 weeks. In
addition, there was no significant difference in overall rate of adverse
experiences between those on paroxetine and those on placebo.
CONCLUSIONS: Paroxetine is both effective and
safe in the acute treatment of social phobia. The findings here are
consistent with those of previous controlled studies of the SSRIs as well as
with previous work done in the USA on the use of paroxetine in the treatment
of this disorder. Early diagnosis and treatment of social phobia
should be encouraged. However, further research on long-term pharmacotherapy
of social phobia is needed.
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