Adding Paroxetine May Not Improve CBT for Social Anxiety

Many treatment options are available for social anxiety disorder (SAD), but as highlighted in a 2014 network meta-analysis (Psychiatric News, November 18, 2014) cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are generally considered the most effective.

But how might these two options directly compare, or work in tandem to treat SAD? There has not been much research in this area, but a clinical study published October 15 in Psychotherapy and Psychosomatics suggests that CBT may be the most effective treatment for SAD compared with the SSRI paroxetine and combined SSRI/CBT treatment.

This study involved 102 adult patients with SAD who were evenly divided into the four treatment groups: 20 to 60 mg paroxetine/day for 26 weeks; 12 CBT sessions, each with a maximum duration of 60 minutes (with the possibility of two booster sessions, if needed), over 12 weeks; paroxetine for 26 weeks with 12 CBT sessions; or placebo pill. The participants, who were naïve to either SSRIs or CBT to reduce any preconceptions about effectiveness, were then assessed after 12 weeks of treatment and again one year from the time treatment ended. …

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