Paroxetine reduces social anxiety in individuals with a co-occurring alcohol use disorder

Book, Sarah W.; Thomas, Suzanne; Randall, Patrick K.; Randall, Carrie L.

doi:10.1016/j.janxdis.2007.03.001

Cited by 59 publications

(49 citation statements)

References 34 publications

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“…In a social phobia study with children and adolescents 12Á17 years of age, paroxetine was superior to placebo . In small DBPC studies in patients with a double diagnosis of SAD and alcohol use, paroxetine showed an effect on social anxiety and on alcohol use (Book et al 2008;Randall et al 2001). In a relapse prevention study, responders were randomized to a further 24 weeks of paroxetine or placebo in the extension of a 12-week single-blind treatment with paroxetine.…”

Section: Summary Of Recommendations For the Treatment Of Gadmentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

711

410

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In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo-or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/ SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

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Section: Summary Of Recommendations For the Treatment Of Gadmentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

711

410

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“…This approach reasonably assumes that reducing AnxD symptoms should reduce the AUD relapse risk associated with AnxD. It has become increasingly clear, however, that this common sense approach has largely failed to improve AUD outcomes significantly for those with a co-occurring AnxD (Book et al, 2008; Bowen et al, 2000; Hobbs et al, 2011; Randall et al, 2001; Schade et al, 2005; Thomas et al, 2008). For example, Hobbs et al (2011) conducted a meta-analysis of 15 controlled randomized studies testing the value of augmenting AUD treatment with either cognitive behavioral therapy (CBT) or medications for a co-occurring AnxD.…”

Section: Introductionmentioning

confidence: 99%

Drinking to cope with negative emotions moderates alcohol use disorder treatment response in patients with co-occurring anxiety disorder

Anker

Kushner

Thuras

et al. 2016

Drug and Alcohol Dependence

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Background Epidemiological studies and theory implicate drinking to cope (DTC) with anxiety as a potent moderator of the association between anxiety disorder (AnxD) and problematic alcohol use. However, the relevance of DTC to the treatment of alcohol use disorder (AUD) in those with a co-occurring AnxD has not been well studied. To address this, we examined whether DTC moderates the impact of two therapies: (1) a cognitive behavioral therapy (CBT) designed to reduce DTC and anxiety symptoms; (2) a progressive muscle relaxation training (PMRT) program designed to reduce anxiety symptoms only. Methods Patients undergoing a standard AUD residential treatment with a co-occurring AnxD (N = 218) were randomly assigned to also receive either the CBT or PMRT. DTC in the 30 days prior to treatment was measured using the Unpleasant Emotions subscale of the Inventory of Drinking Situations. Results Confirming the predicted moderator model, the results indicated a significant interaction between treatment group and level of pre-treatment DTC behavior. Probing this interaction revealed that for those reporting more pre-treatment DTC behavior, 4-month alcohol outcomes were superior in the CBT group relative to the PMRT group. For those reporting less pre-treatment DTC behavior, however, 4-month alcohol outcomes were similar and relatively good in both treatment groups. Conclusions These findings establish a meaningful clinical distinction among those with co-occurring AUD-AnxD based on the degree to which the symptoms of the two disorders are functionally linked through DTC. Those whose co-occurring AUD-AnxD is more versus less strongly linked via DTC are especially likely to benefit from standard AUD treatment that is augmented by a brief CBT designed to disrupt this functional link.

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“…Similarly, in the first paroxetine trial, anxiety symptoms improved a significantly greater degree in the active medication group, but there was no effect on drinking outcome measures (18). The second paroxetine trial had similar results in reducing anxiety symptoms, but alcohol use outcomes were not reported (19).…”

Section: Introductionmentioning

confidence: 85%

“…Four double-blind placebo-controlled trials have studied the use of buspirone to treat alcohol dependence and co-morbid generalized anxiety disorder or anxiety symptoms (14)(15)(16)(17). Two randomized placebo-controlled trials have evaluated paroxetine for alcohol use disorders and comorbid social phobia (18,19). In three of the four buspirone studies, the medication was effective in reducing anxiety symptoms (14,15,17).…”

Section: Introductionmentioning

confidence: 99%

Levetiracetam for the Treatment of Co-Occurring Alcohol Dependence and Anxiety: Case Series and Review

Mariani

Levin

2008

The American Journal of Drug and Alcohol Abuse

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Objectives-Alcohol dependence is frequently associated with anxiety disorders. The exact nature of the relationship between alcohol dependence and anxiety disorders is unknown, but emerging evidence suggests that in a majority of cases, the anxiety disorder is independent of the alcohol use disorder. There is pre-clinical and clinical evidence that levetiracetam, a newer generation anticonvulsant medication, may be efficacious in the treatment of co-occurring alcohol use and anxiety disorders. Methods-In an open label clinical trial, three patients with alcohol dependence and a co-morbid anxiety disorder were treated with levetiracetam in doses up to 1500 mg twice daily for up to 8 weeks.Results-All three participants reported reductions in alcohol consumption and anxiety symptoms during the study period. Levetiracetam was generally well tolerated.Conclusion-This study suggests that levetiracetam deserves further study in the treatment of alcohol dependence and co-occurring anxiety disorders.

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Paroxetine reduces social anxiety in individuals with a co-occurring alcohol use disorder

Cited by 59 publications

References 34 publications

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Drinking to cope with negative emotions moderates alcohol use disorder treatment response in patients with co-occurring anxiety disorder

Levetiracetam for the Treatment of Co-Occurring Alcohol Dependence and Anxiety: Case Series and Review

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