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Cognitive behavioral therapy is the first-line psychotherapy for SAD. Psychodynamic therapy comes in second.

Research suggests that paroxetine is the first-line medication for SAD, and escitalopram comes in second.

Fermented foods such as yogurt can reduce symptoms in SAD in patients with an abnormal gut microbiome.

There are many different treatments for social anxiety disorder (SAD). What to look for?

Both meta-analysis and expert opinion about psychotherapy methods for SAD found that cognitive behavioral therapy (CBT) "was generally the most effective psychotherapy" (Sun, 2025; Baldacara, 2025). CBT can also reduce comorbid depression and general anxiety and improve the quality of life in patients with SAD (Kindred, 2022).

In addition to face-to-face CBT, remote CBT can be effectively delivered via the internet. Remote CBT is "at least as effective, or slightly more effective, than face-to-face treatments" (Winter, 2023).

SAD is often comorbid with other mental disorders, especially depression. Internet therapy for comorbid SAD and depression showed that internet-delivered CBT was "effective in treating individuals with SAD regardless of comorbid depression, and focusing internet CBT interventions on social anxiety can lead to significant reductions in depression among individuals with SAD" (Shalom, 2024).

Patients with both SAD and alcohol use disorder (AUD) "have a higher prevalence of psychiatric comorbidities, mainly major depressive disorder and depressive symptoms" (Oliveira, 2018). Also, there were "higher rates of suicidal thoughts, suicide plans, and attempts in patients with AUD and SAD" (Oliveira, 2018). These patients were less compliant with treatment. This is an example of the need to carefully look for comorbid disorders in patients seeking treatment for SAD.

A meta-analysis showed that psychodynamic therapy (PDT) is "the most effective non-CBT treatment" (Sun, 2025). A different meta-analysis showed "no difference between PDT and CBT for social anxiety disorder" (Zhang, 2022).

Several other psychotherapy methods are used to treat SAD. They include exposure and social skills therapy, self-help therapy, cognitive bias modification, and mindfulness. All of them can be effective for some patients but are generally less........

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