Social anxiety disorder

Question 1

SAD abbr

Answer 1

social anxiety disorder

Question 2

define SAD

Answer 2

a chronic disorder that begins in adolescence and occurs with significant functional impairment and high rates of comorbidity

Question 3

general approach to tx

Answer 3

pharmacotherapy or psychotherapy

pharma is the first choice of tx
for children: offer psychotherapy first

Question 4

-non-pharmacologic therapy

Answer 4

Patient education on disease course, treatment options, and expectations is essential
-CBT

Question 5

pharmacologic thereapy

Answer 5

SSRIs, venlafaxine, phenelzine, benzodiazepines, gabapentin, and pregabalin

SSRIs: 1st-line tx

Question 6

onset for antidepressants

Answer 6

8-12 wks and con’t for at least one year
-many pts will relapse when discon’t

Question 7

SSRIs and venlafaxine

Answer 7

improve social anxiety and phobic avoidance and reduce overall disability
-req tapering off

Question 8

MAOIs

Answer 8

Phenelzine is generally reserved for treatment-refractory patients owing to dietary restrictions, drug interactions, and side effects

Question 9

benzodiazepines

Answer 9

acute relief of physiologic symptoms of anxiety when used concomitantly with antidepressants or psychotherapy
-can also be used as a 2nd-line options if the pt does not have a hx of substance use; long term is not recommended

Question 10

anticonvulsants

Answer 10

gabapentin (max 3600 mg/day) and pregabalin (600mg/day)

Question 11

propranolol or atenolol

Answer 11

should be administered 1 hour before a performance situation
-β-Blockers are not useful for management of SAD