Paroxetine reduces social anxiety in individuals with a co-occurring alcohol use disorder

Abstract

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.

Figure 1

Effect of paroxetine on social anxiety severity indexed by LSAS total scores. Paroxetine (open circles) significantly reduced LSAS scores by week 7 compared to placebo (closed circles), and treatment gains were maintained through week 16. The underlining bar reflects the maintenance phase and where weekly the group means differed at p < .05. Error bars reflect standard error of the mean.