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 .
Brofaromine for social phobia: a multicenter, placebo-controlled, double-blind study.
The safety and efficacy of brofaromine , a reversible and selective monoamine oxidase inhibitor , were examined in a multicenter trial of 102 out patients with social phobia . After a 1-week placebo washout , subjects were r and omly assigned to 10 weeks of treatment with either brofaromine ( N = 52 ) or placebo ( N = 50 ) . Brofaromine dosage began at 50 mg/day and was titrated to a maximum of 150 mg/day , depending on treatment response . Brofaromine produced a significantly greater change from baseline in Liebowitz Social Anxiety Scale ( LSAS ) scores compared with placebo , F(1 ) = 6.01 , p < 0.016 . Mean LSAS scores decreased from 81.8 at baseline to 62.6 at endpoint for brofaromine , t = 5.41,p < 0.001 , and from 79.8 to 70.7 for placebo , t = 3.66 , p < 0.001 . Eleven of the 14 brofaromine  early terminators discontinued because of adverse experiences , as did 4 of the 17 placebo early terminators . Side effects more common with brofaromine than placebo included insomnia , dizziness , dry mouth , anorexia , tinnitus , and tremor . No clinical ly significant variations in vital signs or laboratory values were found . The findings are consistent with the clinical efficacy for the treatment of 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 .