ADD / Social Phobia / MRI Data

Sfcom9 sfcom9 at
Sat Dec 9 12:11:27 EST 1995

Can you - or anyone you know make sense of the following data found on the
neuro-physiology of Social Phobia?

What would you speculate is going on in the brain of a Social Phobic who
is also diagnosed with ADD?

Any elucidation, comment or speculation on the following data - especially
in regards to future treatment directions in a Dual Diagnosis case of ADD
and Social Phobia - will be immensely appreciated!

Social Phobic Data:

* There is some kind of >>Support for a dopaminergic abnormality related
to social phobia...Recent studies have implicated dopamine and the basal
ganglia circuits in the pathophysiology of social phobia.<<

* There seems to be >>growing literature on the processing of information
among persons with social phobia<<.

* No evidence of HPA-axis overactivity found

* Choline and creatine signal-to-noise ratios (SNRs) were significantly
lower in social phobia than in controls (in Choline and creatine
subcortical, thalamic, and caudate areas). 

* In the social phobic group, N-acetylaspartate (NAA) SNR was
significantly lower in cortical and subcortical regions, and ratios of NAA
to other metabolites were lower in social phobia. 

* Choline, creatine, and N-acetylaspartate NAA SNRs were inversely
correlated to total social phobia and fear symptoms, in the thalamic and
noncortical gray areas. 

* In a small number of patients who received clonazepam, posttreatment
SNRs generally increased relative to baseline. 

* <<an age-related reduction in putamen volumes was revealed in patients
with social phobia that was greater than that seen in controls.<<

* MAOI's, Prozac, selective MAOI-A inhibitors and Benzodiazapines have all
been used effectively to help treat social phobia. Most of the press has
gone to the traditional MAOI's. Beta blockers have been of dubious value
and seem least effective.

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