Which medications in the drug class Selective serotonin reuptake inhibitors are used in the treatment of Avoidant Personality Disorder?

Updated: Nov 12, 2019
  • Author: David C Rettew, MD; Chief Editor: Caroly Pataki, MD  more...
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Answer

Selective serotonin reuptake inhibitors

These agents initially block the presynaptic reuptake of serotonin, thereby allowing more of the neurotransmitter to be available in the synapse. Although no medications are approved by the FDA to treat avoidant personality disorder, the SSRIs paroxetine (Paxil) and sertraline (Zoloft) and the SNRI venlafaxine (Effexor) are FDA-approved to treat social anxiety disorder.

SSRIs are greatly preferred over the other classes of antidepressants. Because the adverse effect profile of SSRIs is less prominent, improved compliance is promoted. SSRIs do not have the cardiac arrhythmia risk associated with tricyclic antidepressants. Arrhythmia risk is especially pertinent in cases of overdose, and suicide risk must always be considered when treating a child or young adult with mood disorder.

Physicians are advised to be aware of the following information and use appropriate caution when considering treatment with SSRIs and SNRIs in the pediatric population.

All antidepressants now carry a black box warning regarding elevated rates of suicidal behavior (4% vs 2% on placebo) in short-term studies of children and young adults with depressive and anxiety disorders. Current recommendations include close monitoring of suicidality when starting or increasing any antidepressant. This potential risk is debated within the mental health community.

Sertraline (Zoloft)

Zoloft and other SSRI medications are considered first-line treatment for APD and social phobia. Benefits of SSRIs include relatively high tolerance, ease of administration, and relative safety in overdose.


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