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 .
Phenelzine vs atenolol in social phobia. A placebo-controlled comparison.
Seventy-four patients who met DSM-III criteria for social phobia completed 8 weeks of double-blind , r and omly assigned treatment with the monoamine oxidase inhibitor phenelzine sulfate , the cardioselective beta-adrenergic blocker atenolol , or placebo . The overall response rates were 64 % for phenelzine , 30 % for atenolol , and 23 % for placebo . Phenelzine was widely superior to both  atenolol and placebo  on independent rater analyses and , to a lesser extent , on self-report , with no significant differences between  atenolol  and placebo .  At the end of 16 weeks , phenelzine was still significantly superior to placebo , while  atenolol  showed an intermediate response that did not differ significantly from either of the other treatments . Patients with generalized social phobia  constituted 76 % of the sample , and they were preferentially responsive to phenelzine . The small size of the discrete social phobic sample precluded separate outcome analyses for this subtype . Overall , the findings support the responsivity of social phobia to monoamine oxidase inhibitors
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 .