Therapy target
Improvement of symptomatology
Therapy recommendations
- Antidepressants, if necessary:
- Selective serotonin reuptake inhibitors (SSRIs): paroxetine, escitalopram, sertraline.
- Selective serotonin norepinephrine reuptake inhibitors (SSNRI): venlafaxine.
- Monoamine oxidase inhibitors: moclobemide
- If necessary, short-term, i.e. 2- 4 weeks (due toRisk of dependence): lorazepam, temazepam (benzodiazepines).
- The use of medication can achieve satisfactory therapeutic results only with simultaneous psychotherapy.
- See also under “Further therapy“.
Further notes
- In a network meta-analysis, subsequent therapy methods were presented for initial treatment versus the “waiting group”:
- Pharmacologic therapy: significant effect compared with the waiting group was shown by selective serotonin reuptake inhibitors (SSRIs; have the higher evidence for this indication compared with subsequent pharmaceuticals)/serotonin-norepinephrine reuptake inhibitor (SNRI), benzodiazepines, and MAO inhibitors (phenelzine).
- Psychotherapeutic treatment: significant effect compared with the waiting group was shown by behavioral individual therapy and group behavioral therapy. Here, individual therapy treatment had a greater effect than group therapy.
- Combined treatment: combination of pharmacological and behavioral therapy treatment showed a significant treatment effect compared with the waiting group.
CONCLUSION: For the initial treatment of adults with social phobia, maintenance therapy individual treatment, medication with SSRI/SNRI and a combination of both are equivalent.