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 .
Escitalopram in the treatment of social anxiety disorder: analysis of efficacy for different clinical subgroups and symptom dimensions.
Escitalopram has demonstrated efficacy for the acute treatment of social anxiety disorder ( SAD ) in two placebo-controlled trials and for long-term treatment in a relapse-prevention study . Social anxiety disorder is a heterogeneous disorder . This study questions whether this new selective serotonin reuptake inhibitor is effective across different subgroups of patients . Data from two r and omised , placebo-controlled , 12-week escitalopram SAD trials were pooled . General linear models were used to determine the efficacy of escitalopram in different patient subgroups . Furthermore , a factor analysis of the primary efficacy scale , the Liebowitz Social Anxiety Scale ( LSAS ) , was undertaken , and a determination made of whether treatment effects were similar for the different symptom dimensions . Escitalopram was effective in both younger and older patients , in male and female patients , and in patients with more and less severe social anxiety symptoms .  The LSAS factor analysis showed six factors , which were differentially associated with different areas of disability .  Escitalopram was significantly superior to placebo for all six symptom dimensions . The treatment effects of escitalopram were independent of gender , symptom severity and chronicity , and comorbid depressive symptoms . A six-factor model of social anxiety symptoms is supported by the distinctive association between these symptom dimensions and different areas of disability , but did not predict differential response to escitalopram
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 .