Outcome Evaluation

© Pharmacotherapy of SAD should lead to improvement in physiologic symptoms

of anxiety and fear, functionality, and overall well-being. Many patients may not achieve full remission of symptoms, but they should have significant improvement. Monitor patients weekly during acute treatment (e.g., initiation and titration of pharmacotherapy). Once patients are stabilized, monitor monthly. Inquire about adverse effects and SAD symptoms at each visit. To aid in assessing improvement, ask patients

to keep a diary to record fears, anxiety levels, and behaviors in social situations. You may administer the Leibowitz Social Anxiety Scale (LSAS) to rate SAD severity and change, and the Social Phobia Inventory can be used as a "self-assessment" tool for SAD patients. Lastly, counsel patients on appropriate expectations of pharmacotherapy in SAD, including the gradual onset of effect and the need for extended treatment of at least 1 year.

Abbreviations Introduced in This Chapter

AV At ri oventric u la r

BUN Blood tirea nitrogen c.„ ti 1 Cog n j 11 ve- be ha v io ra i t herapy l)A Dopamine

GABA y-Aminobütyric acid

GAD G ene ra 1 i zed a nx iety d isord er

5-HT Serotonin

IBS Irritable bowl syndrome

LC Locus tcr ulcus

LSAS Liebowitz Social Anxiety Scalc

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