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 .
Mirtazapine Treatment of Social Phobia in Women: A Randomized, Double-Blind, Placebo-Controlled Study
Abstract : Social phobia is an anxiety disorder characterized by extreme fear and phobic avoidance of social and performance situations and by a relatively poor health-related quality of life . The goal of this study was to compare the efficacy of mirtazapine versus placebo in the treatment of patients with social phobia . In 2004 , we conducted a r and omized , double-blind , placebo-controlled study of mirtazapine in 66 female subjects from the general population meeting the criteria for social phobia . The subjects were r and omly assigned in a 1:1 manner to mirtazapine ( n = 33 ) or placebo ( n = 33 ) . The treatment lasted 10 weeks . Seven patients dropped out . Primary outcome measures were self-reported changes on the Social Phobia Inventory , Liebowitz Social Anxiety Scale , and Health Survey ( SF-36 ) . In comparison with the placebo group and according to the intent-to-treat principle , significant differences on the Social Phobia Inventory and Liebowitz Social Anxiety Scale scales ( all P < 0.001 ) , as well as on most ( 5 from 8) scales of SF-36 ( all P < 0.001 ) , were observed in the mirtazapine-treated subjects . All patients tolerated mirtazapine relatively well . Mirtazapine appears to be an effective agent in the treatment of  social phobia in women and in the improvement of their health-related quality of life
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 .