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 in social phobia: a controlled dose-response trial.
Although the monoamine oxidase inhibitor phenelzine has proven efficacious in social phobia , the risk of hypertensive crises has reduced its acceptability . The reversible monoamine oxidase inhibitor moclobemide has less potential for such reactions , but its efficacy in this disorder remains unproven . A double-blind , placebo-controlled study was undertaken to assess the efficacy and safety of fixed doses of moclobemide . After a 1-week placebo run-in , subjects with social phobia were r and omly assigned to placebo or one of five doses ( 75 mg , 150 mg , 300 mg , 600 mg , or 900 mg daily ) of moclobemide for 12 weeks . Although a trend toward greater efficacy of higher doses of moclobemide was observed at 8 weeks , no differences in response to various doses of the drug and placebo were observed at 12 weeks . At 12 weeks , 35 % of subjects on 900 mg of moclobemide and 33 % of those on placebo were at least much improved . Moclobemide was well tolerated , insomnia being the only dose-related adverse event observed with the drug . In this dose-response trial , moclobemide did not demonstrate efficacy at 12 weeks . Some other controlled studies have found moclobemide and  brofaromine  , another reversible monoamine oxidase inhibitor , efficacious in social phobia . Possible reasons for inconsistent findings are discussed
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 .