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 .
Paroxetine in social phobia/social anxiety disorder. Randomised, double-blind, placebo-controlled study. Paroxetine Study Group.
BACKGROUND Preliminary studies have suggested that paroxetine may be effective in social phobia/social anxiety disorder . AIMS To assess the efficacy and tolerability of paroxetine in the acute ( 12-week ) treatment of social phobia . METHOD Two-hundred and ninety patients with social phobia were assigned r and omly to paroxetine ( 20 - 50 mg/day flexible dose ) or placebo for 12 weeks of double-blind treatment . Primary efficacy outcomes were the Liebowitz Social Anxiety Scale ( LSAS ) total score ( patient-rated ) and the Clinical Global Impression ( CGI ) scale global improvement item . The secondary efficacy variables included CGI scale severity of illness score and the patient-rated Social Avoidance and Distress Scale . RESULTS Paroxetine produced a significantly greater reduction in LSAS total score ( mean change from baseline : -29.4 v. -15.6 ; P < or = 0.001 ) and a greater proportion of responders ( score < or = 2 on CGI global improvement ) ( 65.7 % v. 32.4 % ; P < 0.001 ) compared with placebo at the end of the 12-week study period . Both primary efficacy variables were statistically significant compared with placebo from week 4 onwards . Paroxetine was generally well tolerated . CONCLUSIONS Paroxetine is an effective , well-tolerated treatment for patients with social phobia
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 .