Cognitive behavior therapy  appears to be more effective than other evidence -based psychological techniques , and its effects appear to be more enduring than those of pharmacotherapy .
There is some evidence , albeit limited to certain drug classes , that the combination of  medication and cognitive behavior therapy may be more effective than either strategy used alone .
This article proposes a number of recommendations for the treatment of  generalized social phobia  , based on a systematic literature review and meta- analysis .
For medications , selective serotonin reuptake inhibitors and dual serotonin-norepinephrine reuptake inhibitors are first-line choices based on their efficacy and tolerability profiles .
There are other medication classes with demonstrated efficacy in social phobia ( benzodiazepines , antipsychotics , alpha-2-delta lig and s ) , but due to limited published clinical trial data and the potential for dependence and withdrawal issues with benzodiazepines , it is unclear how best to incorporate these drugs into treatment regimens .
Controlled-release paroxetine in the treatment of patients with social anxiety disorder.
BACKGROUND This double-blind , placebo-controlled , flexible-dose study was conducted to investigate the efficacy and tolerability of the controlled-release ( CR ) formulation of paroxetine in adults with social anxiety disorder . METHOD Out patients with a primary diagnosis of social anxiety disorder according to DSM-IV criteria entered a 1-week , single-blind , placebo run-in period . Eligible patients were r and omly assigned to receive paroxetine CR ( flexible dose of 12.5 - 37.5 mg/day ) or placebo for 12 weeks of treatment . The primary efficacy measures were the change from baseline in Liebowitz Social Anxiety Scale ( LSAS ) score and the proportion of responders based on Clinical Global Impressions (CGI)-Global Improvement scale score . Data were gathered from September 2001 to July 2002 . RESULTS The intent-to-treat population consisted of 186 patients r and omly assigned to paroxetine CR and 184 patients r and omly assigned to placebo .  Statistically significant differences in favor of paroxetine CR compared with placebo were observed in the change from baseline to week 12 last-observation-carried-forward ( LOCF ) data set in LSAS total score ( difference = -13.33 , 95 % confidence interval [ CI ] = -18.25 to -8.41 , p < .001 ) . In the CGI-Global Improvement responder analysis , 57.0 % of patients treated with paroxetine CR achieved response ( very much improved or much improved ) , compared with 30.4 % of patients treated with placebo at week 12 LOCF ( odds ratio = 3.12 , 95 % CI = 2.01 to 4.83 , p < .001 ) . Dropout rates due to adverse events were low and comparable in both treatment groups . CONCLUSION Paroxetine CR effectively treated the symptoms associated with social anxiety disorder and was well tolerated , with few patients stopping treatment due to adverse events . This favorable tolerability profile may enable more patients to experience the benefits of effective therapy
Cognitive behavior therapy  appears to be more effective than other evidence -based psychological techniques , and its effects appear to be more enduring than those of pharmacotherapy .
There is some evidence , albeit limited to certain drug classes , that the combination of  medication and cognitive behavior therapy may be more effective than either strategy used alone .
This article proposes a number of recommendations for the treatment of  generalized social phobia  , based on a systematic literature review and meta- analysis .
For medications , selective serotonin reuptake inhibitors and dual serotonin-norepinephrine reuptake inhibitors are first-line choices based on their efficacy and tolerability profiles .
There are other medication classes with demonstrated efficacy in social phobia ( benzodiazepines , antipsychotics , alpha-2-delta lig and s ) , but due to limited published clinical trial data and the potential for dependence and withdrawal issues with benzodiazepines , it is unclear how best to incorporate these drugs into treatment regimens .