Pharmacotherapy for specific phobia in adults
- Richard Swinson, MD
Richard Swinson, MD
- Professor Emeritus
- McMaster University
- Randi E McCabe, PhD
Randi E McCabe, PhD
- Associate Professor of Psychiatry & Behavioural Neurosciences
- McMaster University
Specific phobia is an anxiety disorder characterized by clinically-significant fear of a particular object or situation that typically leads to avoidance behavior. Phobic fears include animals, insects, heights, water, enclosed places, driving, flying, seeing blood, getting an injection, and choking or vomiting.
Specific phobias are among the most common mental disorders and can be highly disabling [1,2]. However, they are also among the most treatable mental disorders [3-6]. Despite availability of efficacious treatments, the majority of individuals with specific phobias are hesitant to seek treatment . This may be due to lack of knowledge that the phobia is treatable, embarrassment to disclose the phobia to a health professional, accommodation of the phobia through avoidance, or fear of increased anxiety or discomfort in the course of treatment .
Pharmacotherapy for specific phobia in adults is discussed here. The epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of specific phobia in adults are discussed separately. Psychotherapy for specific phobia in adults is discussed separately. Specific phobias relating to clinical procedures (eg, blood-injection-injury phobia) and other manifestations of acute procedural anxiety are discussed separately. Specific phobia and other fears in children are also discussed separately. (See "Specific phobia in adults: Epidemiology, clinical manifestations, course and diagnosis" and "Psychotherapy for specific phobia in adults" and "Acute procedure anxiety in adults: Epidemiology and clinical presentation" and "Treatment of acute procedure anxiety in adults" and "Overview of fears and phobias in children and adolescents".).
Pharmacotherapy, including benzodiazepines and serotonergic reuptake inhibitors, has a limited role in treatment of specific phobia. Medications are used when CBT is not available or when patients prefer medication to CBT despite the lack of comparably robust supporting evidence from clinical trials.
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