Posted by Kon on August 8, 2004, at 22:09:35
In reply to whats the best for social phobia???????, posted by woolav on August 7, 2004, at 9:56:07
> Im curious if MAOI's are the only drug that truely work for social phobia....
I'm not sure this is accurate. Two fairly recent meta-analyses suggest that the 3 major drugs used for social phobia are not significantly different wrt effectiveness. In the Blanco (2003)review, the authors write:
"Until relatively recently, pheneline (Nardil)was considered the gold standard in the treatment of SAD. However, results from the meta-analysis suggest that its efficacy is not superior to that of the SSRIs or clonazepam..."
They further write:
"Our analysis found that clonazepam, based on a single study, hadt he largest mean effect size of all medications. The effect sizes of SSRIs and phenelzine (Nardil) were similar to each other and numerically (but not statistically) smaller than those of clonazepam."
I've posted their results below...the higher the score, the more effective the drug.
1. Effect size based on Liebowitz social anxiety scale:
Benzos-1.54
Nardil-1.02
SSRIs-0.652. Effect size based on clinical global impression scale:
Benzos-16.61
Nardil-5.53
SSRIs-4.1In the end, the authors still recommend SSRIs as first-line treatment for SAD partly due to anti-depressive properties of SSRIs over benzos and better safety profile of SSRIs over both benzos and especially Nardil. I personally don't buy this argument which is why Ive chosen the benzo route.
poster:Kon
thread:375033
URL: http://www.dr-bob.org/babble/20040805/msgs/375461.html