Treating individuals with social anxiety disorder and at-risk drinking: phasing in a brief alcohol intervention following paroxetine

J Anxiety Disord. 2013 Mar;27(2):252-8. doi: 10.1016/j.janxdis.2013.02.008. Epub 2013 Mar 4.

Abstract

Paroxetine alone is not sufficient to decrease alcohol use in socially anxious alcoholics seeking anxiety treatment. We tested the hypothesis that adding a brief-alcohol-intervention (BI) to paroxetine would decrease alcohol use. All subjects (N=83) had a diagnosis of social anxiety disorder, endorsed drinking to cope with anxiety, were NIAAA-defined at-risk drinkers, and were randomized to either paroxetine alone, or paroxetine plus BI. Both groups showed significant improvement in both social anxiety severity (F(5,83)=61.5, p<0.0001) and drinking to cope (e.g. F(4,79)=23, p<0.0001) and these two constructs correlated with each other (B=3.39, SE=0.696, t(71)=4.88, p<0.001). BI was not effective at decreasing alcohol use (e.g. no main effect of group, all p values >0.3). Paroxetine decreased social anxiety severity in the face of heavy drinking and decreasing the anxiety was related to a concurrent decrease in coping related drinking. BI was not effective at decreasing drinking or drinking to cope.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Alcohol Drinking / psychology
  • Alcohol Drinking / therapy*
  • Antidepressive Agents, Second-Generation / therapeutic use*
  • Anxiety / drug therapy*
  • Anxiety / psychology
  • Anxiety Disorders
  • Combined Modality Therapy / methods
  • Diagnosis, Dual (Psychiatry)
  • Female
  • Humans
  • Male
  • Paroxetine / therapeutic use*
  • Phobic Disorders / diagnosis
  • Social Behavior Disorders / therapy*

Substances

  • Antidepressive Agents, Second-Generation
  • Paroxetine