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 .
Fluoxetine in Social Phobia: A Double-Blind, Placebo-Controlled Pilot Study
The objective of the study was to examine the efficacy of fluoxetine in  social phobia . Sixty subjects were r and omly assigned to 14 weeks of double-blind therapy with either fluoxetine or placebo . Dose was fixed at 20 mg for fluoxetine during the first 8 weeks of double-blind treatment ; during the final 6 weeks , the dose could be increased every two weeks by 20 mg to a maximum of 60 mg/day . An intentto-treat analysis was used . A significant change from baseline to endpoint was found for both fluoxetine and placebo on the Liebowitz Social Anxiety Scale . However , no significant difference was found between fluoxetine and placebo . The change for fluoxetine was somewhat lower than that found with other selective serotonin reuptake inhibitors , whereas the placebo response was greater .  Fluoxetine failed to separate from placebo in this trial . It is unknown whether a larger dose for longer duration would have yielded separation from placebo . A higher than usual  placebo response rate was found
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 .