Social Anxiety Best Treated by Cognitive Therapy Alone

HealthDay News — Cognitive therapy (CT) is more effective treatment for social anxiety disorder (SAD), compared to paroxetine alone or in combination with CT, according to a study published recently in Psychotherapy and Psychosomatics.

Hans M. Nordahl, PhD, from Norwegian University of Science and Technology in Trondheim, and colleagues randomly assigned 102 patients to paroxetine, CT, the combination of CT and paroxetine, or pill placebo. Treatment with medication lasted 26 weeks. Outcomes were assessed posttreatment and at 12 months.

The researchers found that CT was superior to paroxetine alone and to pill placebo, but was not superior to the combination treatment at the end of treatment. At follow-up, the CT group maintained benefits and was significantly better than placebo and paroxetine alone. However, there were no significant differences among combination treatment, paroxetine alone, and placebo. At 12 months, recovery rates were much higher in the CT group (68 percent) versus the combination group (40 percent), the paroxetine group (24 percent), and the pill placebo group (4 percent).

“Patients often rely more on the medication and don’t place as much importance on therapy. They think it’s the drugs that will make them healthier, and they become dependent on something external rather than learning to regulate themselves,” Nordahl said in a statement. “So the medication camouflages a very important patient discovery: that by learning effective techniques, they have the ability to handle their anxiety themselves.”

Related Articles


Nordahl HM, Vogel, PA, Morken G, Stiles TC, et al. Paroxetine, Cognitive Therapy or Their Combination in the Treatment of Social Anxiety Disorder with and without Avoidant Personality Disorder: A Randomized Clinical Trial. Psychotherapy and Psychosomatics. 2016; 85:346-356 doi:10.1159/000447013