Protein-source tryptophan as an efficacious treatment for social anxiety disorder: a pilot studyThis article is one of a selection of papers published in this special issue (part 1 of 2) on the Safety and Efficacy of Natural Health Products.

2007 ◽  
Vol 85 (9) ◽  
pp. 928-932 ◽  
Author(s):  
Craig Hudson ◽  
Susan Hudson ◽  
Joan MacKenzie
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Phobia ◽  
Social Anxiety Disorder ◽  
Objective Measure ◽  
Serum Levels ◽  
Protein Source ◽  
Intact Protein ◽  
Natural Health Products ◽  
Double Blind

Until recently, intact protein that is rich in tryptophan was not seen as an alternative to pharmaceutical-grade tryptophan because protein also contains large neutral amino acids (LNAAs) that compete for transport sites across the blood–brain barrier. Recent evidence indicates that when deoiled gourd seed (a rich source of tryptophan with approximately 22 mg/g protein) is combined with glucose (a carbohydrate that reduces serum levels of competing LNAAs) a clinical effect similar to that of pharmaceutical-grade tryptophan is achieved. Objective and subjective measures of anxiety in those suffering from social phobia (also known as social anxiety disorder) were employed to measure changes in anxiety in response to a stimulus as part of a double-blind, placebo-controlled, crossover study with a wash-out period of 1 week between study sessions. Subjects were randomly assigned to start with either (i) protein-source tryptophan (deoiled gourd seed) in combination with carbohydrate or (ii) carbohydrate alone. One week after the initial session, subjects returned for a follow-up session and received the opposite treatment of that received at the first session. All 7 subjects who began the study completed the 2-week protocol. Protein-source tryptophan with carbohydrate, but not carbohydrate alone, resulted in significant improvement on an objective measure of anxiety. Protein-source tryptophan combined with a high glycemic carbohydrate is a potential anxiolytic to those suffering from social phobia.

Paroxetine in social phobia/social anxiety disorder

1999 ◽  
Vol 175 (2) ◽  
pp. 120-126 ◽  
Author(s):  
David Baldwin ◽  
Julio Bobes ◽  
Dan J. Stein ◽  
Ingebor Scharwächter ◽  
Michel Faure
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Phobia ◽  
Social Anxiety Disorder ◽  
Severity Of Illness ◽  
Social Avoidance ◽  
Primary Efficacy ◽  
Double Blind ◽  
Global Improvement ◽  
Distress Scale

BackgroundPreliminary studies have suggested that paroxetine may be effective in social phobia/social anxiety disorder.AimsTo assess the efficacy and tolerability of paroxetine in the acute (12-week) treatment of social phobia.MethodTwo-hundred and ninety patients with social phobia were assigned randomly to paroxetine (20–50 mg/day flexible dose) or placebo for 12 weeks of double-blind treatment. Primary efficacy outcomes were the Liebowitz Social Anxiety Scale (LSAS) total score (patient-rated) and the Clinical Global Impression (GGI) scale global improvement item. The secondary efficacy variables included CGI scale severity of illness score and the patient-rated Social Avoidance and Distress Scale.ResultsParoxetine produced a significantly greater reduction in LSAS total score (mean change from baseline: –29.4 v. –15.6; P 0.001) and a greater proportion of responders (score $2 on CGI global improvement) (65.7% v. 32.4%; P < 0.001) compared with placebo at the end of the 12-week study period. Both primary efficacy variables were statistically significant compared with placebo from week 4 onwards. Paroxetine was generally well tolerated.ConclusionsParoxetine is an effective, well-tolerated treatment for patients with social phobia.

Social Anxiety Disorder (Social Phobia)

2009 ◽  
Author(s):  
Vladan Starcevic, MD, PhD
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Phobia ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Generalized Anxiety ◽  
Making Sense ◽  
The Status ◽  
Bona Fide ◽  
Severe Psychopathology

Social anxiety disorder (SAD) is conceptualized as an excessive and/or unreasonable fear of situations in which the person’s behavior or appearance might be scrutinized and evaluated. This fear is a consequence of the person’s expectation to be judged negatively, which might lead to embarrassment or humiliation. Typical examples of feared and usually avoided social situations are giving a talk in public, performing other tasks in front of others, and interacting with people in general. Although the existence of SAD as a psychopathological entity has been known for at least 100 years, it was only relatively recently, with the publication of DSM-III in 1980, that SAD (or social phobia) acquired the status of an ‘‘official’’ psychiatric diagnosis. The term social anxiety disorder has been increasingly used instead of social phobia, because it is felt that the use of the former term conveys more strongly the pervasiveness and impairment associated with the condition and that this term will promote better recognition of the disorder and contribute to better differentiation from specific phobia (Liebowitz et al., 2000). Like generalized anxiety disorder, social anxiety disorder is common and controversial. Unlike generalized anxiety disorder, which is described in different ways by different diagnostic criteria and different researchers and clinicians, SAD does not suffer from a ‘‘description problem.’’ It is not particularly difficult to recognize features of SAD; what may be difficult is making sense of these features. Main issues associated with SAD are listed below…. 1. Where are the boundaries of SAD? How well is SAD distinguished from ‘‘normal’’ social anxiety and shyness on one hand, and from severe psychopathology on the other? 2. Is there a danger of ‘‘pathologizing’’ intense social anxiety by labeling it a psychiatric disorder? How can the distress and suffering of people with high levels of social anxiety be acknowledged if they are not given the corresponding diagnostic label? 3. Is SAD a bona fide mental disorder? 4. Can the subtyping scheme (nongeneralized vs. generalized SAD) be supported? 5. Is there a spectrum of social anxiety disorders?

scholarly journals Early-onset social anxiety disorder in adults: clinical and therapeutic features

2005 ◽  
Vol 27 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Gabriela Bezerra de Menezes ◽  
Leonardo F. Fontenelle ◽  
Márcio Versiani
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Phobia ◽  
Social Anxiety Disorder ◽  
Early Onset ◽  
Late Onset ◽  
Exact Test ◽  
Dsm Iv ◽  
Student’S T ◽  
Psychiatric Complications

OBJECTIVE: To investigate possible differences in clinical and treatment response in patients suffering from early-onset (< 18 years) and late-onset (>18 years) social anxiety disorder. METHODS: Patients diagnosed with social anxiety disorder of early-onset (n = 47; 75.8%) were compared to those diagnosed with late-onset social anxiety disorder (n = 15; 24.2%) in terms of age, mode of onset, subtype, psychiatric comorbidities (according to the Structured Clinical Interview for DSM-IV), symptom severity and response (assessed according to the Clinical Global Impression scale) after at least ten weeks of drug treatment. The statistical analyses included chi² tests with Yates correction or Fisher's exact test, as well as Student's t-test or Mann-Whitney test. The level of statistic significance adopted was 5%. RESULTS: Patients presenting early-onset phobic symptoms more frequently: were inactive (chi² = 4.28; df = 1; p = 0.04); suffered from the generalized subtype of social phobia (chi² = 6.53; df = 1; p = 0.01); and presented psychiatric comorbidity (chi² = 6.71; df = 1; p = 0.01). No differences were observed between the groups in severity of symptoms and therapeutic response. CONCLUSION: The findings suggest the existence of a possible social anxiety disorder subtype characterized by early onset of symptoms, higher rates of absenteeism, a wider range of social phobia symptoms and psychiatric complications.

scholarly journals A Multicenter, Randomized, Double-blind, Placebo-Controlled Trial ofParoxetine in Children and Adolescents With Social Anxiety Disorder

2004 ◽  
Vol 61 (11) ◽  
pp. 1153 ◽  
Author(s):  
Karen Dineen Wagner ◽  
Ray Berard ◽  
Murray B. Stein ◽  
Erica Wetherhold ◽  
David J. Carpenter ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Children And Adolescents ◽  
Social Anxiety Disorder ◽  
Controlled Trial ◽  
Double Blind ◽  
Double Blind Placebo
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