Pharmacological strategies for treating social anxiety disorder in adults: a Systematic review of studies published since 2015

Social anxiety disorder (SAD) is a common and disabling mental disorder that follows a chronic course unless it is treated with effective treatments. This systematic review examines randomized controlled trials (RCTs) of pharmacological treatments for adults with SAD published since 2015. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search was conducted on PubMed, Scopus, Web of Science, and PsycINFO. Risk of bias of the included studies was assessed using the Cochrane risk of bias tool for randomized trials. Eighteen RCTs were included. Selective serotonin reuptake inhibitors (SSRIs) were the most investigated pharmacological intervention, either as monotherapy or in combination with cognitive behavioral therapy (CBT). More recent drugs show promising results include cannabidiol and d-cycloserine. When CBT is unavailable, SSRIs are the first-line pharmacological treatment for SAD based on current evidence. However, response rates vary substantially. We recommend a personalized approach that includes patient preference and treatment accessibility.