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 .
Treatment of social phobia with clonazepam and placebo.
Clonazepam and placebo were administered in a double-blind pilot study to 75 out patients with social phobia . The mean maximum dose of clonazepam was 2.4 mg/day at endpoint ( range , 0.5 to 3 mg ) . Treatment was continued for up to 10 weeks . The results of an intent-to-treat analysis indicated superior effects of clonazepam on most measures . Response rates for clonazepam and placebo were 78.3 and 20.0 % . Drug effects were apparent on performance and generalized social anxiety , on fear and phobic avoidance , on interpersonal sensitivity , on fears of negative evaluation , and on disability measures . Significant differences were evident by week 1 , 2 , or 6 , depending upon the rating scale used . Clonazepam was well tolerated in general , although unsteadiness and dizziness were more severe and persistent than was the case for placebo subjects
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 .