Pharmacotherapy for performance anxiety disorders: occasionally useful but typically contraindicated

Journal of Clinical Psychology
Lee Birk

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.

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Citations

Aug 7, 2009·Applied Psychophysiology and Biofeedback·Sat Bir S KhalsaElyse Sklar
Mar 17, 2006·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Irit Akirav
Mar 4, 2008·Biological Psychiatry·Melissa M NorbergDavid F Tolin
Aug 29, 2006·Neuroscience·M E BertottoI D Martijena
Apr 24, 2014·Behaviour Research and Therapy·Genevra HartR Frederick Westbrook
Sep 23, 2014·Expert Review of Neurotherapeutics·Vladan Starcevic
Sep 28, 2017·The Journal of Nervous and Mental Disease·Dolores VojvodaRobert A Rosenheck

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