Recent findings at our research center here at the Columbia University Medical Center have demonstrated promising steps forward in the development of medications and other treatments which help people with social anxiety disorder.

The efforts of our research team have resulted in reports showing that medications belonging to the class known as the selective serotonin reuptake inhibitors, or SSRI's, are effective in the treatment of social anxiety disorder.  In articles published in 1998 and 2005, Dr. Michael Liebowitz (Director of the Social Anxiety Research Clinic) and his collaborators found Paxil (paroxetine) and Effexor (venlafaxine) to be effective in reducing social anxiety symptoms, without significant side effects for most people.

In 2003, Dr. Carlos Blanco, Dr. Franklin Schneier and their collaborators systematically reviewed all existing reports on medication for social anxiety. They found  several classes of drugs to be helpful.  Serotonin reuptake inhibitors (SSRI's), along with venlafaxine, a drug from a similar class, are good "first-line treatments," in that they can treat social anxiety as well as other problems which often occur at the same time, such as depression.  Some medications originally developed for other problems, such as Nardil (phenelzine), Klonopin (clonazepam), and Neurontin (gabapentin), were found in his review to be effective for social anxiety as a "second-line drug," for use when patients do not respond to SSRI's.

The Social Anxiety Research Clinic, a leader in medication research, joined forces with Dr. Richard Heimberg and his group  (currently at Temple University) in the late 1980s to examine the result when medications are compared with therapy in addressing the problems of social anxiety.  The Temple University lab brought their considerable expertise in a therapy known as "cognitive-behavioral" in that it directly addresses anxious thoughts, or cognitions, and avoidant behavior.  The treatment was conducted in group settings to enhance the opportunity for recreating social situations, thus providing exposure to events that prompt social anxiety.  Participants were trained to challenge their anxious thoughts, and then role-played social interactions.  Medication and therapy were found to be equally effective.

Another focus of the Social Anxiety Research Clinic has been to improve understanding of biological factors that may be related to social anxiety and its treatment.  In the late 1990s, Dr. Schneier and collaborators began to use PET imaging of the brain to measure chemical receptors in the brain.  They focused on the neurotransmitter dopamine, which is known to be important in several emotional processes.  In 2000, a publication by the group demonstrated that persons with generalized social anxiety disorder have significantly fewer dopamine D2 receptors in the limbic system, a region of the brain important in regulating motivated behavior.  Further study of the dopamine system is needed to determine whether these findings can help in the diagnosis and treatment of social anxiety disorder.

Blanco C, Schneier FR, Schmidt A, Blanco-Jerez CR, Marshall RD, Sánchez-Lacay A,   Liebowitz MR (2003)  Pharmacological treatment of social anxiety disorder: A meta-analysis.  Depression and Anxiety, 18:29-40. Heimberg RG. Liebowitz MR. Hope DA. Schneier FR. Holt CS. Welkowitz LA. Juster HR. Campeas R. Bruch MA. Cloitre M. Fallon B. Klein DF. (1998)  Cognitive-behavioral group therapy vs. phenelzine therapy for social phobia: 12-week outcome.  Archives of General Psychiatry, 55(12):1133-41. Liebowitz MR. Gelenberg AJ. Munjack D. (2005)  Venlafaxine extended release vs placebo and paroxetine in social anxiety disorder.  Archives of General Psychiatry, 62(2):190-8. Schneier FR. Liebowitz MR. Abi-Dargham A. Zea-Ponce Y. Lin SH. Laruelle M. (2000) Low dopamine D(2) receptor binding potential in social phobia.  American Journal of Psychiatry, 157(3):457-9. Stein MB, Liebowitz MR, Lydiard RB, Pitts CD, Bushnell W, Gergel I. (1998)  Paroxetine treatment of generalized social phobia (social anxiety disorder): a randomized controlled trial.  Journal of the American Medical Association, 280(8):708-13.

Adult Anxiety Clinic of Temple University For those living in the Philadelphia, PA area, the Adult Anxiety Clinic of Temple University, in collaboration with the Social Anxiety Research Clinic of the New York State Psychiatric Institute and Columbia University is conducting a social anxiety disorder treatment study. The study offers medical evaluation and medication treatment to all eligible participants, who may also receive additional cognitive-behavioral therapy for social anxiety disorder. Treatment and evaluation are provided free of charge to individuals admitted to the research study. The website also provides information and resources on other anxiety disorders. Columbia University New York Presbyterian Hospital Anxiety Disorders Association of America Association for the Advancement of Behavior Therapy Obsessive Compulsive Disorder Research Clinic Obsessive Compulsive Disorder Research Clinic New York State Psychiatric Institute Columbia University College of Physicians and Surgeons New York, NY The website is devoted to education about Obsessive Compulsive Disorder (OCD), and provides information on how to volunteer to participate in Obsessive Compulsive Disorder studies at the New York State Psychiatric Institute. Center for the Study of Trauma & Resilience Center for the Study of Trauma & Resilience New York State Psychiatric Institute and Columbia University New York, NY The website offers information on our research program that includes specialized treatment for 9/11-related PTSD at no cost, and an intensive resilience-building group program offered at September Space in Lower Manhattan. In addition, the website is dedicated to education about Posttraumatic Stress Disorder (PTSD) and grief-related problems, and describes other treatment and research efforts underway at the Center. Columbia Gambling Disorders Clinic The website is devoted to education about Problem Gambling, and provides information on how to get free treatment for problem gambling at the New York State Psychiatric Institute. Visitors can take an online Problem Gambling Self-Assessment that helps determine the severity of their gambling problem. The site also provides information for teens with problem gambling. Depression Evaluation Service This website describes the research studies conducted at the Depression Evaluation Service, an outpatient research and treatment clinic at Columbia University Medical Center and the New York State Psychiatric Institute that offers eligible participants a no-cost psychiatric evaluation and treatment for depression.  In addition, the website offers contact information for current research studies, information about depression in a question-answer format, and suggestions for further resources.