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What is already known on this topic?
Despite the efficacy of treatments for social anxiety disorder (SAD), a percentage of patients do not respond to initial treatment or continue to experience residual symptoms. Given the significant functional impairment and burden associated with SAD, it is important to improve treatment strategies. SSRIs and SNRIs are considered first-line medication treatments; however, less is known about next-step treatments to be implemented if initial pharmacotherapy is unsuccessful.
What does this paper add?
This study is one of the first to systematically examine next-step treatment after unsuccessful initial pharmacotherapy.
In particular, it is one of the first studies to compare the efficacy of augmenting versus switching medications as the next treatment step.
Remission rates did not differ significantly between groups. However, sertraline plus clonazepam showed significantly greater reductions in SAD severity and disability and higher response rates compared with the two other treatments.
It is possible that unblinding may …
Competing interests None.