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Combining escitalopram and cognitive–behavioural therapy for social anxiety disorder: randomised controlled fMRI trial
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2016 (English)In: British Journal of Psychiatry, ISSN 0007-1250, E-ISSN 1472-1465, Vol. 209, no 3, 229-235 p.Article in journal (Refereed) Published
Abstract [en]

Background

Selective serotonin reuptake inhibitors (SSRIs) and cognitive–behavioural therapy (CBT) are often used concomitantly to treat social anxiety disorder (SAD), but few studies have examined the effect of this combination.

Aims

To evaluate whether adding escitalopram to internet-delivered CBT (ICBT) improves clinical outcome and alters brain reactivity and connectivity in SAD.

Method

Double-blind, randomised, placebo-controlled neuroimaging trial of ICBT combined either with escitalopram (n = 24) or placebo (n = 24), including a 15-month clinical follow-up (trial registration: ISRCTN24929928).

Results

Escitalopram+ICBT, relative to placebo+ICBT, resulted in significantly more clinical responders, larger reductions in anticipatory speech state anxiety at post-treatment and larger reductions in social anxiety symptom severity at 15-month follow-up and at a trend-level (P = 0.09) at post-treatment. Right amygdala reactivity to emotional faces also decreased more in the escitalopram+ICBT combination relative to placebo+ICBT, and in treatment responders relative to non-responders.

Conclusions

Adding escitalopram improves the outcome of ICBT for SAD and decreased amygdala reactivity is important for anxiolytic treatment response.

Place, publisher, year, edition, pages
2016. Vol. 209, no 3, 229-235 p.
Keyword [en]
escitalopram, cognitive-behavioural therapy, CBT, ICBT, social anxiety disorder, SAD, fMRI
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-134611DOI: 10.1192/bjp.bp.115.175794ISI: 000383315800010PubMedID: 27340112OAI: oai:DiVA.org:su-134611DiVA: diva2:1034620
Available from: 2016-10-12 Created: 2016-10-12 Last updated: 2017-11-29Bibliographically approved

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CiteExportLink to record
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