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 .
Valproic acid for the treatment of social anxiety disorder
& NA ; The aim of the study was to examine the efficacy of valproic acid in participants with social anxiety disorder . Following a 2‐week single‐blind , placebo run‐in period , 17 participants were enrolled in a 12‐week open flexible‐dose trial of valproic acid ( 500‐2500 mg ) . The primary outcome measures were the mean change from baseline in the Liebowitz Social Anxiety Scale ( LSAS ) total score and responder status [ defined as a Clinical Global Impression of Improvement score ( CGI‐I ) ≤ 2 ] . Social anxiety symptoms as measured by the LSAS and CGI‐I scores significantly improved with treatment . The mean reduction in the LSAS was 21.3 points in the last visit carried forward analysis and 19.1 points for the completer analysis , with 41.1 % and 46.6 % participants , respectively , achieving responder status . The results from this open‐label trial suggest the potential efficacy of valproic acid for the treatment of social anxiety disorder . Placebo‐controlled trials are indicated to confirm these findings
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 .