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 .
Discontinuation of clonazepam in the treatment of social phobia.
Patients with social phobia who responded well to 6 months of open-label treatment with clonazepam  were assigned to receive either continuation treatment ( CT ) with clonazepam for another 5 months , or to undergo discontinuation treatment ( DT ) using a clonazepam taper at the rate of 0.25 mg every 2 weeks , with double-blind placebo substitution . Clinical efficacy was compared between the CT and DT groups using three different social phobia scales . Benzodiazepine withdrawal symptoms were also measured . Relapse rates were 0 and 21.1 % in the CT and DT groups , respectively . Subjects in the CT group generally showed a more favorable clinical response at midpoint and /or endpoint , although even in the DT group clinical response remained good . With respect to withdrawal symptoms , the rates were low in both groups ( 12.5 % for CT and 27.7 % for DT ) with no real evidence suggesting significant withdrawal difficulties . At the end of 11 months of treatment with clonazepam , however , a more rapid withdrawal rate was associated with greater distress . This study offers preliminary evidence to suggest that continuation therapy with clonazepam in the treatment of social phobia is safe and effective , producing a somewhat greater clinical benefit than a slow-taper discontinuation regime . However , even in the DT group , withdrawal symptoms were not found to be a major problem . The study can be taken as supportive of benefit for longterm clonazepam treatment in social phobia , as well as being compatible with a reasonably good outcome after short-term treatment and slow taper
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 .