NAPLEX Examination.
Practice Question # 42.
Naplex
Social anxiety disorder (SAD)
Social anxiety disorder (SAD) is diagnosed when a person has an intense persistent fear of social situations where an individual may be exposed to unfamiliar people or to scrutiny by others. Exposure to the situation produces anxiety that the individual recognizes is unreasonable or excessive. Usually feared situations are avoided or endured with distress. Lastly, SAD symptoms must cause signifi cant distress or impairment and not be accounted for by another medical, psychiatric, or substance use disorder.
SAD Treatment
(1) Antidepressants are fi rst-line treatment of SAD. Paroxetine, sertraline, venlafaxine XR, and fl uvoxamine XR (Luvox XR) are FDA approved. Mirtazapine (Remeron) and phenelzine may be good second-line antidepressants. TCAs are not eff ective in SAD. Onset of eff ect may take 4 to 6 weeks with some patients not achieving maximal benefi t until 12 weeks. Initial antidepressant dosing in SAD is usually half the initial starting dose used in the treatment of depression.
