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 .
Randomised controlled general practice trial of sertraline, exposure therapy and combined treatment in generalised social phobia.
BACKGROUND No controlled trial of treatment of generalised social phobia has been conducted in general practice . AIMS To examine the efficacy of sertraline or exposure therapy , administered alone or in combination in this setting . METHOD Study was of a r and omised , double-blind design . Patients ( n = 387 ) received sertraline 50 - 150 mg or placebo for 24 weeks . Patients were additionally r and omised to exposure therapy or general medical care . RESULTS  Sertraline-treated  patients were significantly more improved than non-sertraline-treated patients ( chi(2)=12.53 , P<0.001 ; odds ratio=0.534 ; 95 % Cl 0.347 - 0.835 ) . No significant difference was observed between exposure- and non-exposure-treated patients ( chi(2)=2.18 , P=0.140 ; odds ratio=0.732 ; 95 % Cl 0.475 - 1.134 ) . In the pairwise comparisons , combined sertraline and exposure ( chi(2)=12.32 ; P<0.001 ) and sertraline ( chi(2)=10.13 ; P=0.002 ) were significantly superior to placebo . CONCLUSIONS Sertraline is an effective treatment for generalised social phobia . Combined treatment with sertraline and exposure therapy , conducted by the general practitioner , may enhance the treatment efficacy in primary care
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 .