Drug for Social Anxiety Disorder

* “Pills for What Ails You Socially” (Opinion, July 23) is wrong to assert that “social anxiety disorder” and the antidepressant medicine used to treat it are “largely the innovation” of the drug’s manufacturer and its ad agency. Specific criteria for diagnosing social anxiety disorder, also called social phobia, have been described in the American Psychiatric Assn.’s Diagnostic and Statistical Manual of Mental Disorders since 1980. Paxil, an antidepressant, was first approved by the Food and Drug Administration for treatment of depression in 1993 and was not approved for treatment of social anxiety disorder until 1999.

Social anxiety disorder is far more than shyness. I know of patients with this disorder who so fear embarrassing themselves before others in social and work situations that they experience acute physical symptoms such as nausea, sweating, shakiness, shortness of breath, dizziness and even chest pain when in these situations.

Drug companies don’t create names for mental illnesses. Psychiatric researchers identify and name mental disorders and classify their signs and symptoms according to emerging scientific data and the extent of human suffering the disorders cause.

Dr. Scott Gottlieb’s hypothesis that medications are being prescribed for some people merely to meet their social expectations is worth exploring. But he loses credibility with sweeping assertions that not only cannot be supported with data but which are incorrect.

DANIEL B. BORENSTEIN MD

Pres., American Psychiatric Assn.

Los Angeles