Alcohol detoxification and social anxiety symptoms: a preliminary study of the impact of mirtazapine administration

J Affect Disord. 2003 Sep;76(1-3):279-84. doi: 10.1016/s0165-0327(02)00094-0.

Abstract

Background: Social anxiety disorder is fairly prevalent among alcohol abusing/dependent subjects. The objective of the present study was to investigate: (a) the incidence of social anxiety symptoms in inpatient alcoholics, (b) the effect of alcohol detoxification on these symptoms, and (c) whether a combined psychotherapeutic/mirtazapine treatment during the post-detoxification phase of alcoholism has a greater impact on the aforementioned symptoms than a non-pharmacological approach.

Method: Social anxiety symptoms were assessed through the Liebowitz Social Anxiety Scale (LSAS) following a 4-5-week detoxification period in two groups: group A (n=21) that followed a detoxification protocol of cognitive-behavioral orientation and group B (n=33) that was assigned to mirtazapine in addition to the standard protocol. Concomitant psychopathology was monitored through the HARS and HDRS, and level of functioning through the GAS.

Results: A marked reduction of social anxiety symptoms was evidenced in both groups. However, patients on mirtazapine improved significantly more compared to controls.

Limitations: A single measure of social anxiety, i.e., the LSAS was used. Also, a longer follow-up period is needed to ascertain remission of social anxiety symptoms.

Conclusions: The present study found a rather high incidence of social anxiety symptoms in inpatient alcoholics which subsided following alcohol detoxification; moreover, it provides preliminary evidence that a combined psychotherapeutic/mirtazapine treatment (30-60 mg/daily) has a greater impact on the aforementioned symptoms than non-pharmacological treatment alone.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adrenergic alpha-Antagonists / therapeutic use*
  • Adult
  • Alcoholism / complications*
  • Alcoholism / psychology
  • Alcoholism / therapy*
  • Combined Modality Therapy
  • Female
  • Humans
  • Inactivation, Metabolic
  • Incidence
  • Inpatients
  • Male
  • Mianserin / analogs & derivatives*
  • Mianserin / therapeutic use*
  • Middle Aged
  • Mirtazapine
  • Phobic Disorders / epidemiology
  • Phobic Disorders / etiology
  • Phobic Disorders / psychology*
  • Psychotherapy*

Substances

  • Adrenergic alpha-Antagonists
  • Mianserin
  • Mirtazapine