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 .
Exposure therapy and sertraline in social phobia: I-year follow-up of a randomised controlled trial.
BACKGROUND Maintenance of treatment effect is important for the choice of treatment for social phobia . AIMS To examine the effect of exposure therapy and sertraline 28 weeks after cessation of medical treatment . METHOD In this study 375 patients with social phobia were r and omised to treatment with sertraline or placebo for 24 weeks , with or without the addition of exposure therapy . Fifty-two weeks after inclusion , 328 patients were evaluated by the same psychometric tests as at baseline and the end of treatment ( 24 weeks ) . RESULTS The exposure therapy group and the placebo group had a further improvement in scores on social phobia during follow-up : mean change in the Clinical Global Impression - Social Phobia overall severity score was 0.45 ( 95 % CI 0.16 - 0.65 , P < 0.01 ) for the exposure group , and 0.25 ( 95 % CI 0.00 - 0.48 , P < 0.05 ) for the placebo group . At week 52 the sertraline plus exposure group and the sertraline-alone group had a significant deterioration on the 36-item Short Form Health Survey compared with exposure alone . CONCLUSIONS Exposure therapy alone yielded a further improvement during follow-up , whereas exposure therapy combined with sertraline and sertraline alone showed a tendency towards deterioration after the completion of treatment
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 .