Social anxiety and propranolol abuse: A case study

Abstract

A patient with severe social anxiety disorder has taken unprescribed propranolol for six years (up to 320 mg/day). In addition to the psychoanalytic treatment that had been instituted and after the diagnosis and prescription of tranilcipromine, both the social anxiety symptoms and propranolol abuse have improved; after the prescription of paroxetine she underwent a better controlled use of the betablocker. Despite the informal self-prescription for several years, the generalized social anxiety symptoms persisted. This case exemplifies the special difficulty of social phobic patients to seek for treatment. The author formulates a hypothesis that there may be an increasing informal prescription of betablockers among persons with social anxiety disorder and performance anxiety, a problem whose public health importance is still unknown.