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 .
Columbia atypical depression. A subgroup of depressives with better response to MAOI than to tricyclic antidepressants or placebo.
We summarise a series of studies using a MAOI to help establish the validity of a subgroup of depressives referred to as atypical depressives . Patients with reactive mood meeting DSM-III criteria for depressive illness who had associated atypical features ( which include hyperphagia , hypersomnolence , leaden paralysis , and rejection sensitivity ) were r and omised to imipramine , phenelzine and placebo . Non-responders were crossed over , and in all there were over 400 patient trials .  Phenelzine consistently was found to be superior to imipramine . Only in trials which included patients lacking atypical ,  vegetative symptoms  was imipramine found to equal phenelzine . We conclude that the research er and the clinician should consider the relevance of the atypical depressive syndrome
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 .