Treating Social Phobias and Social Anxiety

Shyness And Social Anxiety System

The Shyness and Social Anxiety System is just as its name says. It is an e-book wherein in-depth discussions about the symptoms, causes and treatment for shyness and social anxiety are made. It is then written for individuals whose extreme shyness or social anxiety prevent them from enjoying a full life filled with social interactions among their family, friends and acquaintances in gatherings during holidays, outings and parties. The author Sean Cooper also suffered from shyness and social anxiety disorder so much so that he tried every trick in the book yet to no avail. And then he set out to conquer his own fears by researching into the psychology, principles and practices behind these two debilitating mental health issues. More here...

Shyness And Social Anxiety System Summary


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Author: Sean Cooper
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My Shyness And Social Anxiety System Review

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The author presents a well detailed summery of the major headings. As a professional in this field, I must say that the points shared in this book are precise.

All the testing and user reviews show that Shyness And Social Anxiety System is definitely legit and highly recommended.

Dissolve Social Anxiety Home Recovery Program

Here are the benefits youll receive when you sign up for the Dissolve Social Anxiety Program: Get to the Root of your Social Anxiety so you can fully recover. Find out why its Not You thats the cause of your Social Anxiety Disorder. Breakdown Beliefs that fuel social anxiety, to start making changes immediately. Discover how emotions are controlling you, and learn how to stop emotions from controlling your life. Create a new belief system and life story that will become an unshakable foundation so social anxiety never controls you, ever again. Develop new Life Skills, not only to conquer social anxiety, but dissolve virtually Any chronic anxiety or depression that comes along with your social phobia. Get Social Confidence in the way that works best for you, not someone else (this is not a cookie cutter approach Im teaching here). Learn and sharpen social skills to have great social interactions with anyone. Program Features: Instant Access to Twelve (12) life-changing modules to build the skill set to finally dissolve your social anxiety. Practical & Experiential Learning guided exercises to help create new awareness, anxiety reduction/elimination, and new possibilities for Self-Confidence And Social Action. Each module has homework to help reinforce the learning, along with practices to support you in your recovery and transforming your life. Customization for Your specific social anxiety issues and recovery goals. Complete with streaming Video Modules, downloadable MP3 Audio files, Pdf handouts (Just your web browser and Adobe Reader are required) Immediately delivery with a personal membership login for the modules (and question submissions if you purchase a higher level package) More here...

Dissolve Social Anxiety Home Recovery Program Summary

Contents: Online Course
Author: David Hamilton
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Social Anxiety Disorder

This disorder is characterised by anxiety symptoms in social or performance situations, accompanied by a fear of embarrassment or humiliation. Situations are avoided or endured with distress. There may be a specific fear of one or two situations (most commonly public speaking), or of three or more situations in the generalized subtype. Epidemiological studies find this to be the most prevalent anxiety disorder among the general population (Magee et al. 1996). Its peak onset is around the time of adolescence, and the resulting impairments can have a profound effect on social and occupational development. If untreated it tends to follow a chronic, unremitting course. Social anxiety disorder is frequently comorbid with depression, other anxiety disorders, alcohol problems and eating disorders. It is associated with an increased rate of suicide that is significantly higher in the presence of comorbidity (Schneier et al. 1992). drug treatment of choice. Treatment is started at standard...

Social Phobia

Social phobia can be characterized as overwhelming anxiety and excessive self-consciousness in social situations. The fundamental clinical feature of social phobia is a marked and persistent fear of social or performance situations in the presence of unfamiliar people or when scrutiny by others is possible, even in the context of small groups. Examples would be concern about being unable to speak in public or choking on food when eating in a restaurant. Exposure to such social and performance situations provokes an immediate anxiety response or results in maladaptive avoidance behaviour. Associated features of social phobia frequently include poor social skills, hypersensitivity to criticism and negative evaluation and difficulty of being assertive, as well as low self-esteem and feelings of inferiority. This fear of social situations can be associated with physical symptoms such as blushing, sweating, trembling or heart palpitations. Many people with social phobia recognize that...

Diagnoses in Psychiatric Disorders

In an effort to find more effective treatments, some psychiatrists focused on biological investigations. These researchers discovered that PD appears to run in families. They observed temperamental differences among newborns and infants and found that a small minority showed moderate to marked shyness. They demonstrated that panic attacks could be induced by an injection of lactate, a chemical produced by the body during exercise, only in people with panic disorder. They found that medications such as Imipramine and Nardil ameliorated panic attacks. Finally, they demonstrated that benzodiazepines such as Valium and Xanax helped panic attacks, apparently by working on a unique receptor in the brain called the benzodiazepine receptor. The psychiatrists with a biological orientation proposed medications as the only needed treatment.

Regulation of Adult Neurogenesis and Gliogenesis

The effects of intraventricular bFGF are age dependent much more increases in neurons in the neonate than those in the adult are induced following bFGF application (19,20). Brain-derived neurotrophic factor (BDNF) is another mitogenic factor that increases the number of cells and probably the number of neurons in the olfactory bulb after intraventricular injection (21). Like growth factors, hormones exhibit significant influences on adult neurogenesis. Glucocorticoids inhibit adult neurogenesis according to the finding that adrenalectomy increases proliferation of the progenitor population in the hippocampus, and systemic application of glucocorticoids antagonizes this influence (22,23). In contrast, estrogen stimulates neurogenesis in the hippocampus of adult rats (24). Besides growth factors and hormones, multiple neurotransmitter systems show their ability to modulate adult progenitor activity. Glutamatergic transmission in the CNS is the first system studied...

Syndromes of Anxiety and Their Treatment

Social phobia, which is a fear of embarrassment in social or performance situations, is experienced by 10 to 20 percent of the population. Behavioral psychotherapy aimed at helping you maintain calm in increasingly public situations is the most beneficial treatment. SSRIs and TCAs aid many people. Beta-blockers can help you feel calm for a specific event but will not work when taken on a daily basis.

General Information

Escitalopram was efficacious in patients with major depressive disorder in short-term, placebo-controlled trials, three of which included citalopram as an active control, and in a 36-week study in the prevention of relapse in depression (5). It has also been used to treat generalized anxiety disorder, panic disorder, and social anxiety disorder. Results also suggest that, at comparable doses, escitalopram demonstrates clinically relevant and statistically significant superiority to placebo treatment earlier than citalopram. The most common adverse events associated with escitalo-pram include nausea, insomnia, disorders of ejaculation, diarrhea, dry mouth, and somnolence. Only nausea occurred in more than 10 of patients taking escitalopram.

Review of Linkage and Association Studies of Anxiety Disorders

Or have shown to have no association in previous studies (Lappalainen et al. 1998). The two linkage studies (Kennedy et al. 2001 Stein et al. 1998b) of social phobia have been examined by the same group and found to be negative. One genome scan for simple phobia has been performed with a LOD score of 3.17 on chromosome 14 (Gelernter et al. 2003). One positive-association study (Comings et al. 1996) of posttraumatic stress disorder with the A1 allele of the dopamine (D2) receptor polymorphism was not replicated in a subsequent study (Gelernter et al. 1999).

Klaus A Miczek and Jennifer W Tidey Introduction

In fact, amphetamines may be associated with extreme changes in aggressive and social interactions intense and sudden acts of aggression as well as total withdrawal from any social intercourse. These striking, seemingly opposite shifts in social and aggressive behavior under the influence of amphetamines and related substances are the product of numerous pharmacological, behavioral, and environmental, as well as genetic determinants. Another paradox about amphetamines and related psychomotor stimulants is their calming effect on excessively aggressive children and adolescents diagnosed with attention deficit disorder. The neurobiological mechanisms for the multiple effects of amphetamines on aggressive behavior have been most often related to those relevant to the motor-activating and motor-arousing effects of these drugs. Yet, mechanisms of amphetamine action specific to their effects on aggressive and social behavior have eluded a satisfactory delineation.

Anthropological Perspective

Integral to the content of the realm of ayahuasca-induced visions is the cultural context in which they occur. Throughout the tropical rain forests of South America, the traditional ayahuasca-using tribal people have many shared common cultural elements as well as similar contextual themes for their mythologies and ayahuasca-induced experiences. Indeed, some anthropological observers have asserted that it is virtually impossible to separate the nature of the ayahuasca experience from its cultural context (Harner 1973a). Through contacting the supernatural realm of their ancestors, as well as their mythological deities and spirits, the ritual use of ayahuasca has served to bind the communities of disparate individuals into a cohesive collective culture. Culturally syntonic visions are induced by shamanic manipulation of set and setting to provide revelation, blessings, healing, and ontological security for those using such sacramental plants (Grob and Dobkin de Rios 1992). Within...

Possible Significance of Cognitive Differences and MDMA Neurotoxicity

Ing symptoms of neurotoxicity, but we simply do not understand 5-HT or affective disorders sufficiendy to make predictions with any confidence. Late-onset affective disorders probably are influenced by many nonserotonergic factors, such as social isolation and cerebrovascular disease.

Pregnancy Category X

This compound became available in the 1950s. Standard medical uses in males include treatment for delayed puberty and underdeveloped male organs. Experiments demonstrate that fluoxymesterone can improve the growth, weight, and social interactions of boys having slow physical maturation. Compared to some other anabolic steroids, this drug has less tendency to promote masculine body signs (facial hair, deeper voice) in girls, and fluox-ymesterone has been used to nurture increased height in girls. The drug can be administered to treat female sexual dysfunction.

Help the Client Identify Others Who Can Help With the Support Plan

The client may have withdrawn from friends and family who do not use drugs, reducing his or her social circle to only people who use drugs. As the client recognizes the importance of reducing contacts with people who use drugs while trying to overcome dependence, he or she may fear social isolation when he or she needs others' support the most. The counselor explores the nature and extent of the client's social network and suggests expansion of that network as a treatment goal.

Comorbidity with Substance Use Disorders

Ders and alcohol and drug dependence. The odds ratios (ORs) as a measure of association were ranging between 1.8 and 2.7 for alcohol dependence and between 3.3 and 5.2 for drug dependence. Considering the observed ranges of associations within the specific substance dependencies, the available epidemiological findings do not argue for single combinations of disorders having consistently stronger associations than others. Risks rather seem to be of similar magnitude. The ICPE analyses also investigated the temporal ordering of the onset of the comorbid disorders and found that in general, anxiety disorders precede the onset of substance problems disorders. Applying more sophisticated prospective analyses, Zimmermann et al. (2003) could demonstrate based on the 4-year follow-up data of the EDSP that specifically panic disorder and social phobia are predictors of subsequent alcohol problems among adolescents and young adults.

Comorbidity Within the Anxiety Disorders

Although less studied, epidemiological investigation has also shown that there is a considerable degree of overlap within the anxiety disorders. In the NCS, associations (in terms of ORs) within different forms of anxiety disorders were found to range between 3.8 and 12.3 for generalized anxiety disorder, 5.8 and 11.9 for agoraphobia, 4.9 and 8.5 for specific phobia, and 3.8 and 7.8 for social phobia (Wittchen et al. 1994 Magee et al. 1996). The strongest comorbidity was found between panic disorder and agoraphobia, due to the fact that agoraphobia with panic disorder and agoraphobia without panic were not distinguished in the diagnostic criteria of agoraphobia. Interestingly, only about one third of the respondents who meet criteria for DSM-III-R agoraphobia additionally reported panic attacks. This result confirms earlier results found in the ECA and Zurich study (Angst and Dobler-Mikola 1985 Weissman et al. 1986) that panic seems to be involved only in a minority of people with...

Adrenergic Blocking Agents

Investigations into the use of noradrenergic agents as anxiolytics were first directed toward their use in anxious musical performers. -Blockers such as propranolol were found to be useful in alleviating symptoms of anxiety (e.g., palpitations, sweating). Years later, clonidine was shown by Gold et al. (1978) to be effective in blocking physiological symptoms associated with opioid withdrawal. Although not found to be effective in blocking panic, agents such as propranolol, atenolol, and nadolol have been found to be useful when used adjunctively with other agents in reducing symptoms of autonomic arousal associated with panic and social anxiety (Rosenbaum et al. 1998). Importantly, propranolol is metabolized primarily by CYP2D6 and should probably be used in lower dosages in Asians who are slower metabolizers of CYP2D6 substrates.

Clinical Management of Anxiety

Once a diagnosis has been made and explained to the patient, a treatment plan should be negotiated. A range of biological and psychological treatments may be suitable and should be put to the patient, who is offered an element of choice alongside the recommendations of the physician. A combination of drug and psychological therapies can be more effective than either alone (Barlow et al. 2000). The patient may have preconceptions about specific therapies, often as a result of their anxiety, e.g. a patient with panic disorder fears the effects of drugs and a patient with social anxiety baulks at the suggestion of group therapy. An open discussion of benefits and adverse effects, including long-term side-effects, is likely to improve compliance. Although medications are generally well-tolerated, some side-effects commonly occur, and anxious patients experience more than others (Davies et al. 2003). Progress with treatment should be encouraged by regular review, particularly in the early...

Motivation of Change and References to Society and Politics of Self Change

The promotion of a self-change friendly society might include efforts to influence social interactions between addicts and the general population, which may reduce social distance and encourage social support. Such a policy would also take into consideration societal images of various addictions and present counterarguments to addiction-related attributions of dangerousness and blame.

Pharmaceutical interest

Sedative properties 50 mg Kg-100mg Kg of an extract of roots given per os reduces the locomotor activity and extends the dose-dependent pentobarbital sleep of mice. The extract suppresses social isolation-induced aggressive behaviors, but is inactive against pentylenetetrazole-induced convulsion, motor coordination or nociceptive response in group-housed mice. These results suggest that the extract attenuates the pathophysiological changes caused by social isolation stress in mice and in part by the GABAergic system (Thongpraditchote S etal., 1996).

Physical And Emotional Contraindications

The situation is much more complicated in regard to emotional risks. Here the degree of safety is critically dependent on the pre-session emotional balance of the subject, and on the external circumstances. I have never seen adverse aftereffects of an LSD session in an individual who did not have considerable emotional problems prior to the session. In a person who is reasonably balanced and adjusted, the negative sequelae the day after a supervised psychedelic session seldom go beyond such complaints as feelings of fatigue, headache, or hangover. These negative consequences can be much more serious after experiences in complex and erratic social situations, in those instances where the drug was given to an unprepared or even unsuspecting individual, or where traumatic circumstances and pathological interaction complicated the course of the psychedelic reaction.

Behavior of Tac1 and NK1R Knockout Mice in Models of Anxiety

Finally, tacl- - and tac1+ + mice were tested in the social activity paradigm (File 1985). In this paradigm two male mice that were unfamiliar to each other are brought into a novel, brightly lit cage. The social drive of these animals is tempered by the adversity of the situation. More anxious animals explore the new environment rather than investigating the partner. Therefore time spent with social interactions is inversely related to the anxiety state of the animal. The social activity was significantly higher in tac1 ' mice, indicating again reduced levels of anxiety in these animals. The social behavior of the animals was friendly and exploratory, antagonistic behaviors were not observed. Altogether these results strongly suggested that tac1 ' mice were less anxious than tac1+ + animals.

OTC Classification in Japan

Increase muscle mass or height Quality of life improvement Incontinence Impotence Influenza Lifestyle Postpone menstruation Smoking cessation Contraception Weight control Dyspepsia Sun protection Psychological Anti-depression Obsessive-compulsive disorder Social anxiety disorder

Behavioural Inhibition and Parenting Style

Behavioural inhibition describes the tendency to be shy, timid and constrained in unfamiliar situations (Kagan et al. 1984).This disposition is very stable, can be observed early in life and is assumed to be genetically determined. Offspring of parents with anxiety disorders show higher behavioural inhibition than offspring of parents without anxiety disorders (Rosenbaum et al. 1991). Behavioural inhibition has seldom been evaluated in epidemiological studies. However, those that included it consistently found associations between behavioural inhibition during childhood and subsequent development of anxiety disorders. Inconsistent findings, however, have been reported regarding the specificity of behavioural inhibition, i.e. whether behavioural inhibition increases specifically the risk for specific forms of anxiety disorders (social anxiety), all anxiety disorders or other mental disorders (Wittchen et al. 2000a Biederman et al. 2001). Considering the influence of parenting style in...

Monoamine Oxidase Inhibitors

Monoamine oxidase inhibitors (MAOIs) have been shown to be effective in the treatment of anxiety disorders such as social anxiety and panic disorder. In a 12-week, placebo-controlled trial of patients with panic disorder, Sheehan and colleagues reported that phenelzine (45 mg day) was better than placebo however, higher doses of the MAOI (e.g., 60-90 mg day) may be more effective (Sheehan 1980 Buiges1987). Because of the potential risk of a hypertensive crisis with a tyramine-containing diet, the MAOIs have grown less in favor with clinicians, especially since the advent of the SSRIs. MAOIs, however, remain clinically effective agents in the treatment of atypical depression and anxiety disorders, and therefore their metabolism by patients of different ethnic origin remains an important topic of research. MAOIs are predominantly metabolized by CYP2C19 (Bezchlibnzyk-Buler and Jeffries 1999). Its pharma-

Pharmacotherapy for Specific Psychiatric Disorders

Substance-induced disorders (particularly stimulant intoxication and alcohol or sedative-hypnotic withdrawal) can resemble generalized anxiety disorder or panic attacks, and thus, as with depression, at least a two week period of abstinence is preferable prior to initiating pharmacotherapy, although again there is room for judgment. Other anxiety disorders, such as social phobia, agoraphobia, PTSD, or OCD, have distinctive symptoms that do not overlap with symptoms of toxicity or withdrawal. Behavioral approaches are effective for many anxiety disorders and should be considered, first alone and then as a supplement to pharmacotherapy. Antide-pressants are effective for panic disorder or generalized anxiety disorder and have less abuse potential than the benzodi-azepines. Buspirone may be beneficial for generalized anxiety disorder at a dose of at least 45 mg day. If a benzodiazepine is still preferred, expert opinion (supported by some experimental evidence) suggests that the safest...

Attention Deficit Disorders

The early report by Bradley (1937) on beneficial treatment effects with amphetamine in aggressive, destructive, irritable, and hyperactive boys was repeatedly confirmed by double-blind, placebo-controlled studies, Significant reductions in aggressive behavior and improvements in social interactions were found after treatment with 10 to 40 mg day of d- or l-amphetamine for boys and girls, 5 to 14 years of age, who had been diagnosed as

Panic Disorder and Agoraphobia

Panic disorder is comorbid with episodes of depression at some stage in the majority of cases (Stein et al. 1990), with social anxiety disorder and to a lesser extent GAD and PTSD, and with alcohol dependence and personality disorder. Comorbidity results in increased severity and poor response to treatment. Panic disorder is associated with a significantly increased risk of suicide, and this is increased further by the presence of comorbid depression (Lepine et al. 1993).

Psychological psychiatric

Social phobia has been attributed to amfetamine (49). A 26-year-old woman reported flushing, sweating, palpitation, and shortness of breath, in a range of social situations. She was described as a confident and extroverted woman, with no history of psychiatric problems. The authors speculated that dopaminergic dysfunction, reported by some to underlie social phobia, could have resulted in this case from chronic amfetamine-related striatal dopamine depletion.

Most Parents Dont Know If Their Teen Is Depressed

Obesidad Sobrepeso Quotes

The difficulty in resolving these opposing arguments is that there are very few clinical studies which track the safety and efficacy of many new antidepressants currently prescribed for teenagers. In fact, many of these antidepressants are not officially mandated for use in adolescents. What's more, several antidepressants are prescribed for syndromes and behavioral problems that are off-label, meaning these antidepressants have not been officially studied for treatment of these syndromes, such as social phobia or obsessive-compulsive disorder. The danger of doing this is that the metabolism and biochemistry of an adolescent brain may process anti-depressants differently than an adult brain. For instance, there have been reports of teenagers being prescribed normal doses of Wellbutrin that caused them to swing into bipolar mania. Only for ADHD have there been extensive safety and efficacy studies of drugs like Ritalin (methylphenidate). However, at the same time, psychiatrists are...

Tricyclic Antidepressants

This group includes compounds with actions on a range of neurotransmitter systems. Their antidepressant efficacy is mediated by reuptake inhibition of serotonin and noradrenaline, although side-effects such as sedation may also be useful. Their use in anxiety disorders is supported by a long history of clinical experience and a reasonable evidence base from controlled trials. Studies support the use of clomipramine (a potent serotonin reuptake inhibitor) in panic disorder and OCD (Lecrubier et al. 1997 Clomipramine Collaborative Study Group 1991), of imipramine in panic disorder and GAD (Cross-National Collaborative Panic Study 1992 Rickels et al. 1993), and of amitriptyline in PTSD (Davidson et al. 1993a). No controlled studies support the use of TCAs in social anxiety disorder.

The Pioneering Studies

A few years later, the Australian psychiatrist Les Drew (1968) called attention to the fact that a large number of clinical studies unanimously showed that the quotient of identified alcoholics, in relation to the population in a specific age-group, tended to peak prior to the age of 50 years and then decrease substantially. Drawing on the results of other studies, Drew acknowledged that one reason for the reduction of alcohol problems in older age groups might be related to increased mortality among alcohol abusers and, to a lesser degree, the beneficial effects of treatment. However, viewing these explanations as insufficient, he also found reason to conclude that a process of self-change probably accounts for a significant proportion of alcohol abusers who cease to appear in alcohol statistics as their age increases. As potential forces involved in such a process, Drew suggested a number of factors accompanying aging (e.g., increasing maturity and responsibility, decreasing drive,...

Family Genetic Factors

One of the major risk factors for the development of an anxiety disorder is a family history of psychopathology. In several epidemiological studies the familial aggregation of anxiety disorders was demonstrated (Angst 1998 Kendler et al. 1997 Kessler et al. 1997 Bromet et al. 1998 Lieb et al. 2000b Wittchen et al. 2000a Chartier et al. 2001 Bijl et al. 2002). On the basis of the Munich EDSP-study, Lieb et al. (2000b) could demonstrate that offspring of parents with social phobia have an increased risk for social phobia vs offspring mentally healthy of parents (see Fig. 2). This study found, in addition, that risk for social phobia seems also to be elevated among offspring of parents with other psychopathology, e.g. other anxiety disorders, depression or alcohol use disorders, suggesting a familial cross-transmission of these disorders. Fig. 2 Onset of social phobia among respondents with parents with social phobia, parents with psychopathology, excluding social phobia, and those whose...

Pregnancy Category D

Clonazepam is considered one of the more powerful benzodiazepine class drugs. Primary medical uses are against some kinds of convulsions, particularly in certain kinds of epilepsy, and against panic attacks. For persons suffering from panic attacks, measurements indicate the drug improves both quality of life and work productivity. The drug is also used as an antidepres-sant and to treat anxiety, catatonia, obsessive-compulsive disorder, the manic phase of manic-depressive behavior, and social phobia in general. A two-year follow-up study of persons receiving brief clonazepam treatment for social phobia found their improvement to be sustained after dosage stopped, and at the two-year mark they were doing better than a control group that had received a placebo. Clonazepam is sometimes preferred over alprazolam in treating anxiety because that condition seems less likely to reappear between doses of clonazepam than between doses of alprazolam. Clonazepam can be substituted for...

Phobic Disorders

Though there are far fewer controlled family and twin studies of the other anxiety subtypes, all of the phobic states (i.e., specific phobia, agoraphobia) have also been shown to be familial (Fyer et al. 1995 Noyes et al. 1987 for review, see Merikangas and Angst 1995). The average relative risk of phobic disorders in the relatives of phobics is 3.1. Stein et al. (1998a) found that the familial aggregation of social phobia could be attributed to the generalized subtype of social phobia. Data from the Virginia Twin Study report the estimated total heritability for phobias to be 0.35 (Kendler et al. 1992).


Lived in large all-male colonies, produced hyperactivity and social withdrawal in the initial phase of drug exposure after about a week a high incidence of startle, threat, and defensive responses was seen (Ellison 1978 Eison et al. 1978). Similar, chronically implanted amphetamine capsules in vervet monkeys again resulted in hallucinatory-like grooming, grasping, and head movements, and disrupted social interactions without evidence for tolerance development (Nielsen and Lyon 1982). These progressively more pronounced social withdrawal and motor stereotypies are also seen in groups of macaques or marmosets that are administered amphetamine daily (Garver et al. 1975 Ridley et al. 1979). So far, neither tolerance nor sensitization to amphetamine's effects on withdrawal from all social and aggressive interactions has been seen in the very few studies that either examined changes in the ongoing rate of these behaviors during the course of repeated amphetamine administration or that...

Opioid Antagonists

In experiments with mice and squirrel monkeys, we confirmed and extended the antagonism of amphetamine-induced motor hyperactivity by naltrexone at the same time, however, amphetamine's disruption of aggressive and social behavior was not reversed by naltrexone (Winslow and Miczek, in press). Specifically, in mice, the resident's attack and threat behavior toward an intruder was even further reduced by amphetamine after naltrexone pretreatment (figure 7). Squirrel monkeys that are dominant within their social group exhibit significantly lower levels of aggressive display toward other group members and initiate fewer social interactions after amphetamine treatment naltrexone did not block these effects. The interactive effects of amphetamine and naltrexone on locomotor behavior are consistent with the proposed modulation of dopamine-mediated functions by opioids however, the interaction between amphetamine and naltrexone on social behavior appears to involve a different mechanism.


As a class, benzodiazepines are efficacious for the treatment of many anxiety disorders, including panic disorder, social anxiety disorder, generalized anxiety disorder, alcohol withdrawal, and situational anxiety. Although obsessive-compulsive disorder falls within the taxonomy of anxiety disorders, benzodiazepines do not seem to be particularly effective in treating these patients. The BZDs may be contraindicated in the ongoing treatment of PTSD though open-label studies have suggested efficacy, a recent double-blind study found no benefit, and it is believed that BZDs may cause depression in such patients and potentially worsen the course of the disorder. There are concerns about dependency and stigma associated with the use of benzodiazepine medications. The benzodiazepines clonazepam and alprazolam have been shown to be efficacious in treating social anxiety disorder. The potential for abuse and drug withdrawal is a particularly problematic issue in social anxiety disorder...


Methylphenidate's prime medical use is for managing attention deficit hyperactivity disorder (ADHD), a condition in which people are so excitable that they have severe problems with social interactions. The affliction is more common in children than adults, and methylphenidate seems more effective against ADHD in children, though one study finds the drug to have little influence on long-term outcome. Limited success is seen in experimental usage of the drug to help autistic children. A case report says a regimen of that drug and the antidepressant sertraline (Zoloft) cured a young kleptomaniac. Among adults methylphenidate is typically prescribed for narcolepsy and has also been used successfully against apathy and depression. Despite the drug's occasional tendency to increase blood pressure, studies find the substance promising for rehabilitation of persons recovering from stroke and other brain injuries, not only improving mood but also helping ability to move.

Age of Onset

Data from the WHO International Consortium in Psychiatric Epidemiology (ICPE), which carried out cross-national comparative studies on the prevalence and correlates of mental disorders, investigated the distribution of age of onset for the overall diagnostic group of anxiety disorder including panic disorder, agoraphobia, simple phobia, social phobia and generalized anxiety disorder. Fig. 1 shows graphically the findings that this group obtained across six countries. Regarding the specific types of anxiety disorders, specific and social phobia show the earliest manifestations (see Wittchen et al. 1999a). The main risk period for these anxiety disorders lies in childhood or adolescence, and after age 20 the probability for first onset considerably decreases. In contrast, generalized anxiety disorder, panic disorder and OCD manifest somewhat later, during late adolescence until middle adulthood (Burke et al. 1990 Magee et al. 1996 Wittchen et al. 1999a). Thus, for generalized anxiety...


Data from epidemiological studies consistently have shown that anxiety disorders are more common in women than in men. On average, anxiety disorders are about twice as frequent in women (Kessler et al. 1994 Alonso et al. 2004 Jacobi et al. 2004). Although there are variations across the specific forms of anxiety disorders (female male ratio ranging between 1.5 and 2.5), the overall higher risk for women remains stable. The lifetime and 12-month prevalences of agoraphobia, specific phobia, generalized anxiety disorder, panic disorder and posttraumatic stress disorders are approximately twice as prevalent among women as men (Eaton et al. 1991 Kessler et al. 1994 Magee et al. 1996 Bijl et al. 1998 Alonso et al. 2004 Jacobi et al. 2004). Across the surveys, smaller sex differences were found for social phobia and OCD (Magee et al. 1996 Bijl et al. 1998 Alonso et al. 2004 Jacobi et al. 2004).

Life Events

And the subsequent development of anxiety disorders (Ernst et al. 1993 Fer-gusson et al. 1996 Kessler et al. 1997 Bijl et al. 1998 Chartier et al. 2001 DeGraaf et al. 2002). Molnar et al. (2001) evaluated on the basis of the NCS data the relationship between child sexual abuse and subsequent mental disorders. They found that, among women, child sexual abuse increases the risk for agoraphobia, panic disorder, posttraumatic stress disorder and social phobia. Among men, only posttraumatic stress disorder was associated with child sexual abuse. Similar specific findings were recently reported by MacMillan et al. (2001) who found significant associations between child sexual abuse and subsequent anxiety disorders only among women. Other life events that have been investigated include parental divorce, death of parents and early separation from parents, but to date these factors have not consistently been proved as risk factors for the development of anxiety disorders.


This category contains various drugs that are licensed for the treatment of psychotic disorders. Their effects are mediated via antagonism of D2 dopamine receptors in the limbic system and cortex. They are loosely divided into two groups older classical drugs such as haloperidol and chlorpromazine that are potent D2 blockers and atypical antipsychotics that have a lower affinity for D2 receptors but also block 5-HT2 receptors. The history of clinical use of classical antipsychotics as major tranquillisers has little support from controlled trials (El-Khayat and Baldwin 1998). Evidence is greatest in OCD for the augmentation of SSRI treatment with haloperidol (McDougle et al. 1994) and the atypical drugs risperidone (McDougle et al. 2000) and quetiapine (Atmaca et al. 2002). Recent controlled trials have reported benefits for the atypical drug olanzapine in social anxiety disorder (Barnett et al. 2002) and in addition to SSRIs in PTSD (Stein et al. 2002). Open studies are reporting...


Citalopram Brain Serotonin

Than the TCAs in overdose, but the excessive activation of serotonergic systems can culminate in the 5-HT syndrome, a life-threatening delirium. All SSRIs have other clinical applications, such as in treatment of bulimia, anxiety disorders (e.g. obsessive compulsive disorder, panic disorder, social phobia) and Seasonal Affective disorder.

Specific Phobia

The key feature of specific phobia is an intense and persistent fear of circumscribed situations or specific stimuli (e.g. exposure to animals, blood). Confrontation with the situation or stimulus provokes almost invariably an immediate anxiety response. Often, the situation or stimulus is therefore avoided or endured with considerable dread. Adolescents and adults with this disorder recognize that this anxiety reaction is excessive or unreasonable, but this may not be the case in children. For a diagnosis according to DSM-IV, the avoidance, fear or anxious anticipation of the phobic stimulus must interfere with the persons daily life or the person must be markedly distressed about having the phobia. Further, the phobic reactions are not better explained by another mental disorder, such as, for example, social phobia.


Alcohol's effect on GABA receptors in the cerebral cortex probably accounts for the initial excitement, increased emotionality, and loss of behavioral restraint that occurs soon after a drinker has the first couple of drinks. This explains why Todd and the girls decided it was okay to drive, even though they all knew better. The enhanced GABA effect appears first to disrupt higher cognitive processes, the kind that depend on experience, memory, and practice to perform well. These kinds of cognitive processes underlie accurate perception, good judgment, and smooth social interactions. Todd lost these abilities soon after he started drinking, because these processes depend on information processing that is highly complicated and that requires complex neural circuits with lots of synapses. It is easier to disrupt a process with more synapses (neurons), because it only takes failure at a few synapses for the whole circuit to fail. In other words, by enhancing inhibitory inputs, alcohol...

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