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 vs interpersonal psychotherapy in social anxiety disorder: a randomized controlled trial.
CONTEXT Cognitive therapy ( CT ) focuses on the modification of biased information processing and dysfunctional beliefs of social anxiety disorder ( SAD ) . Interpersonal psychotherapy ( IPT ) aims to change problematic interpersonal behavior patterns that may have an important role in the maintenance of SAD . No direct comparisons of the treatments for SAD in an outpatient setting exist . OBJECTIVE To compare the efficacy of CT , IPT , and a waiting-list control ( WLC ) condition . DESIGN R and omized controlled trial . SETTING Two academic outpatient treatment sites . Patients Of 254 potential participants screened , 117 had a primary diagnosis of SAD and were eligible for r and omization ; 106 participants completed the treatment or waiting phase . INTERVENTIONS Treatment comprised 16 individual sessions of either CT or IPT and 1 booster session . Twenty weeks after r and omization , posttreatment assessment was conducted and participants in the WLC received 1 of the treatments . MAIN OUTCOME MEASURES The primary outcome was treatment response on the Clinical Global Impression Improvement Scale as assessed by independent masked evaluators . The secondary outcome measures were independent assessor ratings using the Liebowitz Social Anxiety Scale , the Hamilton Rating Scale for Depression , and patient self-ratings of SAD symptoms . RESULTS At the posttreatment assessment , response rates were 65.8 % for CT , 42.1 % for IPT , and 7.3 % for WLC . Regarding response rates and Liebowitz Social Anxiety Scale scores , CT performed significantly better than did IPT , and both treatments were superior to WLC . At 1-year follow-up , the differences between CT and IPT were largely maintained , with significantly higher response rates in the CT vs the IPT group ( 68.4 % vs 31.6 % ) and better outcomes on the Liebowitz Social Anxiety Scale . No significant treatment × site interactions were noted . CONCLUSIONS Cognitive therapy and IPT led to considerable improvements that were maintained 1 year after treatment ; CT was more efficacious than was IPT in reducing social phobia symptoms
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 .