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Pharmacotherapy for performance anxiety disorders: occasionally useful but typically contraindicated.

Abstract
Pharmacotherapy is an effective part of treatment for most anxiety disorders, but not for specific phobia or performance anxiety. In them it is contraindicated, because it interferes with the effectiveness of exposure therapies and the extinction of fear responses. Interference with exposure-extinction is a drug side effect that should rarely if ever be tolerated in treating them. This article reviews the many indications for pharmacotherapy in treating most anxiety disorders and contrasts its usefulness in treatment of anxiety disorders with its relatively rare usefulness in treating specific phobias and performance anxiety. In both the latter disorders, benzodiazepines interfere with exposure and generally are best avoided, although temporary use, with safeguards, can sometimes be helpful for a specific phobia. The recent discovery that D-cycloserine (DCS) facilitates exposure and the extinction of anxiety offers promise that it could in the future be usefully and broadly employed to catalyze and enhance exposure therapies.
AuthorsLee Birk
JournalJournal of clinical psychology (J Clin Psychol) Vol. 60 Issue 8 Pg. 867-79 (Aug 2004) ISSN: 0021-9762 [Print] United States
PMID15241814 (Publication Type: Journal Article, Review)
CopyrightCopyright 2004 Wiley Periodicals, Inc.
Chemical References
  • Antimetabolites
  • Cycloserine
Topics
  • Antimetabolites (therapeutic use)
  • Anxiety Disorders (drug therapy)
  • Cycloserine (therapeutic use)
  • Extinction, Psychological
  • Fear
  • Humans
  • Panic Disorder (drug therapy)
  • Speech
  • Task Performance and Analysis

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