{"id":841,"date":"2025-03-24T13:50:23","date_gmt":"2025-03-24T04:50:23","guid":{"rendered":"https:\/\/wako-psy-clinic.com\/kimoto\/?p=841"},"modified":"2025-03-24T13:50:23","modified_gmt":"2025-03-24T04:50:23","slug":"%ef%bc%92%ef%bc%90%e6%ad%b3%e6%9c%aa%e6%ba%80%e3%81%ae%e7%a4%be%e4%ba%a4%e4%b8%8d%e5%ae%89%e9%9a%9c%e5%ae%b3%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e3%80%81%e8%96%ac%e7%89%a9%e7%99%82%e6%b3%95%e3%81%a8tm","status":"publish","type":"post","link":"https:\/\/wako-psy-clinic.com\/kimoto\/blog\/841.html","title":{"rendered":"\uff12\uff10\u6b73\u672a\u6e80\u306e\u793e\u4ea4\u4e0d\u5b89\u969c\u5bb3\u306b\u5bfe\u3059\u308b\u3001\u85ac\u7269\u7642\u6cd5\u3068TMS\u6cbb\u7642\u306e\u6709\u52b9\u6027\u306b\u3064\u3044\u3066\u3001\u795e\u5948\u5ddd\u770c\u539a\u6728\u5e02\u306e\u5150\u7ae5\u7cbe\u795e\u79d1\u533b\u304c\u89e3\u8aac"},"content":{"rendered":"\n
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20\u6b73\u672a\u6e80\u306e\u793e\u4ea4\u4e0d\u5b89\u969c\u5bb3\u306b\u5bfe\u3059\u308b\u85ac\u7269\u7642\u6cd5\u3068TMS\u6cbb\u7642\u306e\u6709\u52b9\u6027\u306b\u3064\u3044\u3066
\u793e\u4ea4\u4e0d\u5b89\u969c\u5bb3\uff08SAD: Social Anxiety Disorder\uff09\u306f\u3001\u601d\u6625\u671f\u304b\u3089\u9752\u5e74\u671f\u306b\u304b\u3051\u3066\u767a\u75c7\u3057\u3084\u3059\u304f\u3001\u5bfe\u4eba\u95a2\u4fc2\u3084\u5b66\u6821\u751f\u6d3b\u306b\u5927\u304d\u306a\u5f71\u97ff\u3092\u4e0e\u3048\u307e\u3059\u3002\u85ac\u7269\u7642\u6cd5\u3068TMS\u6cbb\u7642\uff08\u7d4c\u982d\u84cb\u78c1\u6c17\u523a\u6fc0\u6cbb\u7642\uff09\u306f\u3001\u7279\u306b\u91cd\u5ea6\u306e\u75c7\u4f8b\u3084\u3001\u8a8d\u77e5\u884c\u52d5\u7642\u6cd5\uff08CBT\uff09\u3060\u3051\u3067\u306f\u6539\u5584\u304c\u96e3\u3057\u3044\u5834\u5408\u306b\u6709\u52b9\u306a\u9078\u629e\u80a2\u3068\u306a\u308a\u307e\u3059\u3002

1. 20\u6b73\u672a\u6e80\u306e\u793e\u4ea4\u4e0d\u5b89\u969c\u5bb3\u306b\u5bfe\u3059\u308b\u85ac\u7269\u7642\u6cd5\u306e\u6709\u52b9\u6027
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2. 20\u6b73\u672a\u6e80\u306e\u793e\u4ea4\u4e0d\u5b89\u969c\u5bb3\u306b\u5bfe\u3059\u308bTMS\u6cbb\u7642\u306e\u6709\u52b9\u6027
\u2460 TMS\u6cbb\u7642\u3068\u306f\uff1f
TMS\uff08Transcranial Magnetic Stimulation, \u7d4c\u982d\u84cb\u78c1\u6c17\u523a\u6fc0\u7642\u6cd5\uff09\u306f\u3001\u78c1\u6c17\u30d1\u30eb\u30b9\u3092\u7528\u3044\u3066\u8133\u306e\u7279\u5b9a\u306e\u9818\u57df\u3092\u523a\u6fc0\u3057\u3001\u795e\u7d4c\u306e\u6d3b\u52d5\u3092\u8abf\u6574\u3059\u308b\u975e\u4fb5\u8972\u7684\u306a\u6cbb\u7642\u6cd5\u3067\u3059\u3002
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\u307e\u3068\u3081
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\ud83d\udccc 20\u6b73\u672a\u6e80\u306e\u793e\u4ea4\u4e0d\u5b89\u969c\u5bb3\u3067\u306f\u3001\u307e\u305a\u306f\u5fc3\u7406\u7642\u6cd5\uff08CBT\uff09\u3092\u4e2d\u5fc3\u306b\u884c\u3044\u3001\u5fc5\u8981\u306b\u5fdc\u3058\u3066\u85ac\u7269\u7642\u6cd5\u3084TMS\u6cbb\u7642\u3092\u4f75\u7528\u3059\u308b\u306e\u304c\u7406\u60f3\u7684\u306a\u6cbb\u7642\u6226\u7565\u3067\u3059\u3002

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Today, I\u2019d like to discuss the effectiveness of medication and TMS (Transcranial Magnetic Stimulation) therapy for social anxiety disorder (SAD) in individuals under the age of 20.

Social Anxiety Disorder in Adolescents: Medication & TMS Therapy
Social Anxiety Disorder (SAD) often develops during adolescence and can significantly impact school life and social relationships. While Cognitive Behavioral Therapy (CBT) remains the first-line treatment, medication and TMS therapy can be highly effective in moderate to severe cases, or when CBT alone is insufficient.

1. Effectiveness of Medication for SAD in Individuals Under 20
\u2460 SSRIs (Selective Serotonin Reuptake Inhibitors) \u2013 First-Line Medication
SSRIs are commonly used to treat the core symptoms of SAD such as excessive fear, anxiety, and social avoidance.

\u2705 Clinical Benefits:

Well-supported by evidence in pediatric SAD

Reduces anxiety and promotes social adaptation

Helps decrease avoidance behaviors

\ud83d\udccc Common SSRIs:

Paroxetine (Paxil): Potent anti-anxiety effect but risk of withdrawal symptoms

Escitalopram (Lexapro): Fewer side effects; suitable for youth

Fluvoxamine (Luvox): Effective for social anxiety in public situations

\ud83d\udccc Side Effects:

Initial increase in anxiety

Nausea, dizziness, drowsiness

Weight gain, sexual dysfunction (long-term use)

\ud83d\udccc Important Notes:

Takes 2\u20134 weeks to show effect

Should not be discontinued suddenly to avoid withdrawal symptoms

\u2461 Benzodiazepines \u2013 For Short-Term Use Only
Benzodiazepines may be used temporarily in severe cases of anxiety or panic, but carry a high risk of dependence, especially in younger patients.

\ud83d\udccc Common Benzodiazepines:

Lorazepam (Ativan): Quick onset for acute anxiety

Alprazolam (Xanax): Effective for social situations but use with caution

\ud83d\udccc Side Effects:

Drowsiness, fatigue

Memory issues (with long-term use)

Dependency risk

\ud83d\udccc Important Notes:

Should be avoided in youth unless absolutely necessary

Limit use to a few weeks, only under strict medical supervision

2. Effectiveness of TMS Therapy for SAD in Individuals Under 20
\u2460 What is TMS?
Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation therapy that uses magnetic pulses to modulate brain activity.
It is FDA- and Japan MHLW-approved for depression and OCD, and research is increasingly supporting its use for SAD.

\u2705 In SAD:
Low-frequency TMS to the right dorsolateral prefrontal cortex (right DLPFC) has been shown to be effective.
It helps regulate overactive fear circuits in the brain.

\u2705 Ideal for:

Patients who don\u2019t respond well to medications

Those concerned about medication side effects

\u2461 Clinical Evidence for TMS
Right DLPFC low-frequency TMS reduces social anxiety symptoms

Balances serotonin and GABA activity in the brain

Improves fear in presentation settings and reduces avoidance of social situations

\ud83d\udccc TMS Advantages:

Non-invasive and safe

Minimal side effects

Long-lasting effects possible, even after discontinuation

\ud83d\udccc TMS Limitations:

Not covered by insurance in Japan (private treatment only)

Requires frequent sessions (typically 5x\/week for 4\u20136 weeks)

Response rates around 50\u201360%

Summary
\u2705 SSRIs are the first-line pharmacological option, showing strong long-term efficacy.
\u2705 Benzodiazepines are for short-term emergency use only, due to dependence risks.
\u2705 TMS is a promising, non-drug-based therapy\u2014especially valuable for those who are medication-resistant or wary of side effects.
\u2705 Low-frequency right DLPFC TMS has shown positive results in treating social anxiety disorder.

\ud83d\udccc In patients under 20, the ideal treatment plan begins with CBT, followed by medication or TMS if symptoms persist.

Additional Notes from Dr. Kato:
As I always emphasize, medications should only be used when the benefits clearly outweigh the risks.

If a person has some symptoms of social anxiety but does not meet the full diagnostic criteria, medication may not help and may cause more side effects.

Both SSRIs and benzodiazepines can cause withdrawal symptoms, so caution is required when stopping them.

TMS offers a safe alternative that does not carry dependence risks.

Avoiding anxiety-inducing situations may lead to increased anticipatory anxiety, creating a vicious cycle.
Medications, when used safely, can help break that cycle\u2014but only if used correctly.

If you or your child are struggling with social anxiety, please don\u2019t hesitate to consult our clinic.
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