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 .
Moclobemide is effective and well tolerated in the long-term pharmacotherapy of social anxiety disorder with or without comorbid anxiety disorder
Social phobia ( social anxiety disorder ) is a highly prevalent and chronic disorder that is associated with significant comorbidity and disability . Despite recent advances in the pharmacotherapy of the disorder , there is a paucity of r and omized controlled trials on patients with comorbid disorders and on maintenance treatment . A r and omized placebo-controlled , double-blind multi-site trial of moclobemide , a reversible inhibitor of monoamine oxidase A , was undertaken with 390 subjects . After an initial 12 weeks , there was the option of continuing for an additional 6 months of treatment . The primary efficacy parameter chosen was responder status as defined by the Clinical Global Impression scale change item . From week 4 onwards , there was a significantly higher response rate on moclobemide than on placebo .  Superiority of medication over placebo was similar in patients with comorbid anxiety disorders ( 33 % of subjects ) and without , as well as in patients with different subtypes of social anxiety disorder ; indeed , treatment with moclobemide rather than placebo was the strongest predictor of response . Adverse events were similar across treatment groups , and were typically mild and transient . In the extension phase , response rates remained higher in the moclobemide group , and ratings of tolerability were equally high in both groups . Thus , in a large sample of social anxiety disorder patients with and without comorbid anxiety disorders , moclobemide was both effective and well-tolerated in the short as well as long-term . These data confirm and extend previous findings on the value of moclobemide in the treatment of social anxiety disorder , and strengthen the range of therapeutic options for managing this important disorder
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 .