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 .
Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial.
Sixty patients meeting Diagnostic and Statistical Manual of Mental Disorders ( 4th ed . : American Psychiatric Association , 1994 ) criteria for generalized social phobia were assigned to cognitive therapy ( CT ) , fluoxetine plus self-exposure ( FLU + SE ) , or placebo plus self-exposure ( PLA + SE ) . At posttreatment ( 16 weeks ) , the medication blind was broken . CT and FLU + SE patients then entered a 3-month booster phase . Assessment s were at pretreatment , midtreatment , posttreatment , end of booster phase , and 12-month follow-up . Significant improvements were observed on most measures in all 3 treatments . On measures of social phobia , CT was superior to FLU + SE and PLA + SE at midtreatment and at posttreatment . FLU + SE and PLA + SE  did not differ . CT remained superior to FLU + SE at the end of the booster period and at 12-month follow-up . On general mood measures , there were few differences between the
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 .