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 .
Efficacy of Venlafaxine ER in patients with social anxiety disorder: a double‐blind, placebo‐controlled, parallel‐group comparison with paroxetine
This study evaluated the anxiolytic efficacy , safety and tolerability of a flexible dose of venlafaxine extended release ( ER ) compared with placebo and paroxetine in the short‐term treatment of generalized social anxiety disorder ( SAD ) . Adult out patients with generalized SAD ( n = 434 ) were r and omized to receive capsules of venlafaxine ER 75 mg to 225 mg/day , paroxetine 20 mg to 50 mg/day , or placebo for 12 weeks . The primary efficacy variable was the Liebowitz social anxiety scale total score . Secondary efficacy variables included the patient‐rated social phobia inventory and the proportion of responders in each group ( a responder was defined as having a clinical global impression‐improvement score of 1 or 2 ) . Treatment with venlafaxine ER was associated with significantly greater improvement than treatment with placebo for all primary and secondary efficacy variables ( p < 0.05 ) . No significant differences in primary or secondary efficacy variables were observed between the venlafaxine ER and paroxetine groups . The week 12 response rates were 69 % , 66 % and 36 % for the venlafaxine ER , paroxetine and placebo groups , respectively . Both active treatments were generally well tolerated and were associated with a similar incidence of adverse events . This study shows that venlafaxine ER is an effective , safe and well‐tolerated drug treatment for SAD . Copyright © 2004 John Wiley & Sons ,
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 .