General Approach to Treatment

Patients with SAD may be managed with pharmacotherapy or psychotherapy. There is insufficient evidence to recommend one treatment over the other, and data are lacking on the benefits of combining treatment modalities. Pharmacotherapy often is the first choice of treatment owing to relative greater access and reduced cost compared with psychotherapy.60 Patients with SAD generally respond slowly to treatment, and many will not achieve a full response. Relapse is common when patients are discontinued after effective short-term treatment. Patients generally are continued on treatment for at least 1 year before attempting discontinuation.

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