Common Changes in Cerebral Blood Flow in Patients With Social Phobia Treated With Citalopram or Cognitive-Behavioral Therapy

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Abstract
COMMUNITY SURVEYS indicate that at least 20% of the US population have anxiety disorders1 and that the annual societal cost of these disorders exceeds $63 billion in 1998 dollars.2 This underscores the importance of developing efficacious antianxiety treatments, which could be facilitated by a greater understanding of the brain regions involved in anxiety reduction. In the past decade, it was learned that selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, are helpful not only in depression but also for patients with anxiety disorders.3 The SSRIs are generally considered to enhance serotonergic neurotransmission in the brain, but the neural mechanisms whereby these drugs alleviate anxiety symptoms are not well characterized. Similarly, psychological treatments such as cognitive-behavioral therapy are effective in reducing anxiety, but little is known about how successful psychotherapy exerts its beneficial effect in the central nervous system.