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 pregabalin in generalized social anxiety disorder: results of a double-blind, placebo-controlled, fixed-dose study
The objective of this study was to evaluate the efficacy and tolerability of pregabalin for the treatment of generalized social anxiety disorder ( SAD ) . Patients with generalized SAD , who met the Diagnostic and Statistical Manual of Mental Disorders ( fourth edition ) criteria ( total N=329 ) , were r and omly assigned to 11 weeks of double-blind treatment with fixed daily doses of either pregabalin ( 300 , 450 , and 600(mg ) or placebo . The treatment with pregabalin ( 600(mg ) was associated with a significantly greater mean reduction in the Liebowitz Social Anxiety Scale total score , from baseline to endpoint , compared with placebo ( -29.8 vs. -19.7 ; P= 0.0099 ) , whereas reduction on pregabalin ( 300(mg , -20.2 ) and pregabalin ( 450(mg , -25.5 ) was not significant Treatment with pregabalin ( 600(mg ) was also associated with a significantly greater improvement than placebo on the fear and avoidance subscales of the Liebowitz Social Anxiety Scale , as well as the majority of other secondary measures . Onset of improvement occurred by week 1 in the pregabalin 600-mg dose group . The most common adverse events on all three doses of pregabalin were somnolence and dizziness . Consistent with a previous study , the results of this study suggest that the 600-mg dose of pregabalin per day may be efficacious in the treatment of SAD
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 .