A large study from the Johns Hopkins Bloomberg School of Public Health has found results that go against the accepted wisdom for the treatment of social anxiety disorder. For years, antidepressants have been the most commonly prescribed treatment for social anxiety disorder (SAD). However, the new study analyzed data from 101 clinical trials featuring 13,164 SAD patients and discovered that cognitive behavioral therapy is both more effective and longer lasting as a treatment for this mental disorder. For this extensive analysis, lead researcher Evan Mayo-Wilson, Ph.D., of the Bloomberg School collaborated with researchers from Oxford University and University College London in the United Kingdom.
Medication Was Compared to Several Different Forms of Talk Therapy
Of the more than 13,000 patients in the 101 clinical trials, approximately 9,000 were treated for SAD with medication or a placebo, while approximately 4,000 received talk therapy. The meta-analysis of this large collection of data found that talk therapy was overall a more effective form of treatment than drug therapy. Of the various forms of talk therapy, the analysis showed that cognitive behavioral therapy produced the best results for more patients in both the short term and the long term.
Medications Have Side Effects, Reduced Long-Term Effectiveness
The study did not find medication to be an entirely ineffective way to treat SAD. However, there were some drawbacks associated with medication, typically antidepressants, which were not a factor with cognitive behavioral therapy. One potential drawback of medication is side effects. Not every person who takes antidepressants will experience one or more of the potential side effects, but some patients do experience adverse effects that can include nausea, insomnia, constipation, dizziness, appetite growth and weight gain. In addition, antidepressants are typically only effective for patients while they are taking them. SAD is a lifelong condition for many people, and any symptoms that are alleviated by antidepressants usually return once a patient stops taking the antidepressant. In contrast, a course of cognitive behavioral therapy can be completed in several weeks and provide patients with insights and tools that they can use for the rest of their lives. In addition, medication has a higher rate of failure than talk therapy. Medication does not provide any symptom relief for some patients, while cognitive behavioral therapy produces very consistent positive results.
Medication More Accessible for Many Patients
While cognitive behavioral therapy may be the preferred method of treating social anxiety disorder, it may not be a viable option for everyone with this illness. Financial limitations and provider limitations both make this form of therapy difficult for some patients to access. In the United States, there is a shortage of trained psychotherapists who can provide cognitive behavioral therapy. As a result, some patients may find that this therapy is not available where they live. Patients who do have trained psychotherapists in their area may encounter long waits before they are able to schedule appointments and begin the treatment process. Cognitive behavioral therapy is also less frequently covered by medical insurance than antidepressants and other forms of medication. When patients and doctors encounter these difficulties, it is easy to turn to medication as an affordable and comparatively rapid solution to social anxiety disorder, despite the drawbacks. Social anxiety disorder is a relatively common illness in the United States and Europe, affecting around 13 percent of the populations of these two regions. New treatment guidelines for this disorder have already appeared in the United Kingdom as a result of this large data analysis.
