Buspirone in social phobia

The novel anxiolytic agent buspirone has been shown to be effective in generalized anxiety disorder, but its utility in phobic disorders is less clear. We examined its efficacy in social phobia in a 12-week open trial. Twenty-one patients who met DSM-III-R criteria for social phobia and who did not respond to 1 week of single-blind placebo were treated with buspirone, and 17 completed a mini-mum of 2 weeks of treatment. Twelve of these 17 patients met criteria for the generalized subtype of social phobia. At week 12, 8(47%) of the 17 patients were rated much to very much improved in social phobia symptoms on the Clinical Global Impression Scale. Of the 12 patients who were able to tolerate a dose of 45 mg/day or more, 9 (67%) were at least much improved. Significant improvement was noted on measures of social anxiety and avoidance of social situations. Ratings of generalized anxiety and depression, which were low at baseline, did not change significantly during treatment. The results suggest that buspirone may have modest efficacy in the treatment of social phobia, but confirmation in a placebo-controlled trial is required.