[Expectancies and SSRI treatment of social anxiety disorder]

Lakartidningen. 2024 Nov 11:121:24007.
[Article in Swedish]

Abstract

The efficacy of escitalopram in treating social anxiety disorder is significantly influenced by expectations shaped through communication, contributing to about half the improvement. Overt SSRI treatment with accurate information about its effectiveness doubled the clinical outcome compared to covert treatment with misinformation about the therapeutic effect. Clinical improvements are not solely due to serotonin reuptake inhibition, as indicated by similar serotonin transporter occupancy in both treatment types, without correlation to anxiety reduction. There was, however, notable correlation between clinical improvement and reduced dopamine transporter availability in the overt SSRI group, possibly due to increased dopamine turnover. This was also observed in a study on combined CBT and SSRI treatment. Conversely, clinical improvement after CBT combined with placebo showed an inverse correlation with dopamine transporters and did not inhibit serotonin transporters.

Publication types

  • Review
  • English Abstract

MeSH terms

  • Citalopram / therapeutic use
  • Cognitive Behavioral Therapy
  • Escitalopram / pharmacology
  • Escitalopram / therapeutic use
  • Humans
  • Phobia, Social* / drug therapy
  • Selective Serotonin Reuptake Inhibitors* / pharmacology
  • Selective Serotonin Reuptake Inhibitors* / therapeutic use
  • Treatment Outcome

Substances

  • Selective Serotonin Reuptake Inhibitors
  • Escitalopram
  • Citalopram