A study from The British Journal of Psychiatry found that adding escitalopram to internet-delivered cognitive behavioral therapy (ICBT) improved the outcome for social anxiety disorder and reduced amygdala reactivity necessary for treatment response to anxiolytics.

Not many studies have evaluated the effect of combining selective serotonin reuptake inhibitors (SSRIs) and CBT to treat social anxiety disorder though they are commonly used together. Malin Gingnell, MD, PhD, Uppsala University, Sweden, and colleagues looked at whether adding escitalopram to ICBT improved clinical outcomes and modified brain reactivity and connectivity in patients with SAD. They conducted a double-blind, randomized, placebo-controlled neuroimaging trial of ICBT combined with either escitalopram (n=24) or placebo (n=24); the study included a 15-month clinical follow-up.

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The data showed escitalopram + ICBT led to significantly more clinical responders, more reductions in anticipatory speech state anxiety at post-treatment, and more reductions in social anxiety symptom severity at 15-month follow-up and at a trend-level after treatment, when compared with placebo + ICBT. The right amygdala reactivity to emotional faces was also reduced in the escitalopram + ICBT arm vs. placebo + ICBT arm, as well as in treatment responders vs. non-responders. 

For more information visit bjp.rcpsych.org.