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 .
Efficacy of sertraline in severe generalized social anxiety disorder: results of a double-blind, placebo-controlled study.
BACKGROUND Generalized social anxiety disorder is an early onset , highly chronic , frequently disabling disorder with a lifetime prevalence of approximately 13 % . The goal of the current study was to evaluate the efficacy and tolerability of sertraline for the treatment of severe generalized social anxiety disorder in adults . METHOD After a 1-week single-blind placebo lead-in period , patients with DSM-IV generalized social phobia were r and omly assigned to 12 weeks of double-blind treatment with flexible doses of sertraline ( 50 - 200 mg/day ) or placebo . Primary efficacy outcomes were the mean change in the Liebowitz Social Anxiety Scale ( LSAS ) total score and the responder rate for the Clinical Global Impressions-Improvement scale ( CGI-I ) , defined as a CGI-I score < /= 2 . Data were collected in 2000 and 2001 . RESULTS 211 patients were r and omly assigned to sertraline  ( intent-to-treat [ ITT ] sample , 205 ) , and 204 patients , to placebo  ( ITT sample , 196 ) . At week 12 , sertraline produced a significantly greater reduction in LSAS total score compared with placebo ( mean last-observation-carried-forward [ LOCF ] change from baseline : -31.0 vs. -21.7 ; p = .001 ) and a greater proportion of responders ( CGI-I score < /= 2 : 55.6 % vs. 29 % among week 12 completers and 46.8 % vs. 25.5 % in the ITT-LOCF sample ; p < .001 for both comparisons ) . Sertraline was well tolerated , with 7.6 % of patients discontinuing due to adverse events versus 2.9 % of placebo-treated patients . CONCLUSION The results of the current study confirm the efficacy of sertraline in the treatment of severe social anxiety disorder
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 .