Amphetamine Misuse and Social Phobia

Ms. A, a 26-year-old woman, was seen after 2 months of flushing, sweating, palpitations, and shortness of breath, which occurred in a range of social situations. The first episode happened in a staff canteen, when she became aware of her colleagues staring at her and felt embarrassed. At her assessment she had given up work and had started avoiding various activities for fear of reexperiencing similar feelings. She had no past psychiatric history, and before these attacks she had been confident and extroverted. She had been taking 1.5 g of street amphetamine orally almost daily for 6 years.

Initially, she felt good while taking the drug, but she currently used it to help her “get going.” There was no temporal relationship between her anxiety symptoms and her amphetamine ingestion; the attacks occurred specifically in social situations. She showed no symptoms of affective disturbance or psychotic symptoms. A diagnosis of generalized social phobia was made.