Glucocorticoid Treatment for Social Phobia

Summary

Social phobia is the third most common psychiatric disorder besides depression and alcoholism. Several studies have demonstrated the efficacy of cognitive-behavioral therapy in the treatment of social phobia. Nevertheless, there is no effect in a third of the people at the existing treatment methods. Pharmacological therapies have similar effects, but there is a high rate of relapse after discontinuation of medication. Social phobia is characterized by fear of performance or interaction situations. The strong fear of negative evaluation by others is usually accompanied by a marked avoidance behavior and increased physical symptoms such as blushing, sweating, palpitations, or tremors. The confrontation with a phobic stimulus leads to a retrieval of stimulus-associated aversive memories, resulting in an immediate anxiety response. Several studies had already shown that elevated glucocorticoids impair retrieval of declarative memory contents in healthy subjects. The investigators demonstrated an anxiety-reducing effect after the administration of cortisone before the confrontation with a phobic stimulus in patients with social and spider phobia.

Timeline

Start

2009-07

Primary completion

2012-03

Completion

2012-04

Publications

• Background Soravia LM, de Quervain DJ, Heinrichs M. Glucocorticoids do not reduce subjective fear in healthy subjects exposed to social stress. Biol Psychol. 2009 Jul;81(3):184-8. doi: 10.1016/j.biopsycho.2009.04.001. Epub 2009 Apr 11.
• Background de Quervain DJ, Roozendaal B, Nitsch RM, McGaugh JL, Hock C. Acute cortisone administration impairs retrieval of long-term declarative memory in humans. Nat Neurosci. 2000 Apr;3(4):313-4. doi: 10.1038/73873. No abstract available.
• Background de Quervain DJ, Roozendaal B, McGaugh JL. Stress and glucocorticoids impair retrieval of long-term spatial memory. Nature. 1998 Aug 20;394(6695):787-90. doi: 10.1038/29542.
• Background Aerni A, Traber R, Hock C, Roozendaal B, Schelling G, Papassotiropoulos A, Nitsch RM, Schnyder U, de Quervain DJ. Low-dose cortisol for symptoms of posttraumatic stress disorder. Am J Psychiatry. 2004 Aug;161(8):1488-90. doi: 10.1176/appi.ajp.161.8.1488.
• Soravia LM, Schwab S, Weber N, Nakataki M, Wiest R, Strik W, Heinrichs M, de Quervain D, Federspiel A. Glucocorticoid administration restores salience network activity in patients with spider phobia. Depress Anxiety. 2018 Oct;35(10):925-934. doi: 10.1002/da.22806. Epub 2018 Aug 12.

Drugs

Indications