非典型抗精神病药
需要对非典型抗精神病药（如奥氮平、喹硫平、阿立哌唑）进行进一步研究。小规模的随机对照试验证实其治疗社交恐惧症可能有效。[102]Barnett SD, Kramer ML, Casat CD, et al. Efficacy of olanzapine in social anxiety disorder: a pilot study. J Psychopharmacol. 2002 Dec;16(4):365-8.http://www.ncbi.nlm.nih.gov/pubmed/12503837?tool=bestpractice.com[103]Schutters SI, van Megen HJ, Westenberg HG. Efficacy of quetiapine in generalized social anxiety disorder: results from an open-label study. J Clin Psychiatry. 2005 Apr;66(4):540-2.http://www.ncbi.nlm.nih.gov/pubmed/15816800?tool=bestpractice.com[104]Depping AM, Komossa K, Kissling W, et al. Second-generation antipsychotics for anxiety disorders. Cochrane Database Syst Rev. 2010;(12):CD008120.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008120.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/21154392?tool=bestpractice.com 不良反应（如体重增加以及代谢性综合征）可能限制了一些患者的应用。
丁螺环酮
尽管有一些作者支持使用丁螺环酮以扩大其他治疗策略，[105]Van Ameringen M, Mancini C, Wilson C. Buspirone augmentation of selective serotonin reuptake inhibitors (SSRIs) in social phobia. J Affect Disord. 1996 Jul 8;39(2):115-21.http://www.ncbi.nlm.nih.gov/pubmed/8827420?tool=bestpractice.com 但许多对照临床试验未能证实其作为单药治疗对社会焦虑障碍有效。[69]Roy-Byrne PP, Cowley DS. Pharmacological treatments for panic disorder, generalized anxiety disorder, specific phobia, and social anxiety disorder. In: Nathan P, Gorman JM, eds. A guide to treatments that work. 3rd ed. New York, NY: Oxford University Press; 2007:337-66.[105]Van Ameringen M, Mancini C, Wilson C. Buspirone augmentation of selective serotonin reuptake inhibitors (SSRIs) in social phobia. J Affect Disord. 1996 Jul 8;39(2):115-21.http://www.ncbi.nlm.nih.gov/pubmed/8827420?tool=bestpractice.com
环丝氨酸
这是一个部分N-甲基-D-天冬氨酸激动剂。小剂量的使用可以通过巩固记忆来提高对于社交焦虑暴露治疗的有效性。[106]Guastella AJ, Richardson R, Lovibond PF, et al. A randomized controlled trial of D-cycloserine enhancement of exposure therapy for social anxiety disorder. Biol Psychiatry. 2008 Mar 15;63(6):544-9.http://www.ncbi.nlm.nih.gov/pubmed/18179785?tool=bestpractice.com 一项比较在认知行为疗法（CBT）治疗社交焦虑中增加环丝氨酸和安慰剂的多地点、随机试验发现，两者反应和缓解率相似，尽管在积极治疗中，环丝氨酸组的症状改善和缓解速度快了24%到33%。[107]Hofmann SG, Smits JA, Rosenfield D, et al. D-Cycloserine as an augmentation strategy with cognitive-behavioral therapy for social anxiety disorder. Am J Psychiatry. 2013 Jul;170(7):751-8.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058999/http://www.ncbi.nlm.nih.gov/pubmed/23599046?tool=bestpractice.com 由于环丝氨酸在焦虑障碍（包括社交恐惧症）中的证据不一致，需要进行更多的随机试验。
初级医疗保健干预
在初级医疗保健中的诸如选择认知行为疗法、药物治疗或联合治疗干预的患者较常规治疗的患者来说，在减少焦虑和抑郁症状、降低功能失调以及提高生活质量方面效果更好，即使是在18个月后的随访时也一样。[60]Roy-Byrne P, Craske MG, Sullivan G, et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA. 2010 May 19;303(19):1921-8.http://jama.jamanetwork.com/article.aspx?articleid=185888http://www.ncbi.nlm.nih.gov/pubmed/20483968?tool=bestpractice.com
人与人之间的心理治疗
此疗法为对抑郁的有效治疗，也能够成为社交恐惧症的有效心理学干预。[108]Lipsitz JD, Gur M, Vermes D, et al. A randomized trial of interpersonal therapy versus supportive therapy for social anxiety disorder. Depress Anxiety. 2008;25(6):542-53.http://www.ncbi.nlm.nih.gov/pubmed/17941096?tool=bestpractice.com
基于网络的认知行为心理治疗（CBT）
基于认知行为疗法原则的治疗可以通过网络方式获得。网络有助于扩大对那些无法获得认知行为疗法临床治疗的患者的干预。基于网络的干预也能够有效减少社交焦虑患者的抑郁和广泛性焦虑共病症状。[109]Titov N, Gibson M, Andrews G, et al. Internet treatment for social phobia reduces comorbidity. Aust N Z J Psychiatry. 2009 Aug;43(8):754-9.http://www.ncbi.nlm.nih.gov/pubmed/19629797?tool=bestpractice.com[110]Dear BF, Staples LG, Terides MD, et al. Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for social anxiety disorder and comorbid disorders: a randomized controlled trial. J Anxiety Disord. 2016 Aug;42:30-44.http://www.sciencedirect.com/science/article/pii/S0887618516300639http://www.ncbi.nlm.nih.gov/pubmed/27261562?tool=bestpractice.com 结局研究表明，基于网络的认知行为疗法可产生的积极治疗反应与个人、个体[110]Dear BF, Staples LG, Terides MD, et al. Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for social anxiety disorder and comorbid disorders: a randomized controlled trial. J Anxiety Disord. 2016 Aug;42:30-44.http://www.sciencedirect.com/science/article/pii/S0887618516300639http://www.ncbi.nlm.nih.gov/pubmed/27261562?tool=bestpractice.com 和认知行为治疗团体干预相类似。[111]Hedman E, Andersson G, Ljotsson B, et al. Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: a randomized controlled non-inferiority trial. PLoS One. 2011 Mar 25;6(3):e18001.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070741/?tool=pubmedhttp://www.ncbi.nlm.nih.gov/pubmed/21483704?tool=bestpractice.com 一项针对社交焦虑个体的研究发现，在完成网络认知行为疗法 5 年后，Liebowitz 社交焦虑量表显示其仍旧存在较大的影响。[112]Hedman E, Furmark T, Carlbring P, et al. A 5-year follow-up of internet-based cognitive behavior therapy for social anxiety disorder. J Med Internet Res. 2011 Jun 15;13(2):e39.http://www.jmir.org/2011/2/e39/http://www.ncbi.nlm.nih.gov/pubmed/21676694?tool=bestpractice.com 一篇系统评价认为网络认知行为疗法是对社交恐惧症的卓有成效的治疗。[113]Hedman E, Ljótsson B, Lindefors N. Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost-effectiveness. Expert Rev Pharmacoecon Outcomes Res. 2012 Dec;12(6):745-64.http://www.ncbi.nlm.nih.gov/pubmed/23252357?tool=bestpractice.com其他系统评价表明，无指导的网络 CBT 所获得的结果与有治疗师支持的网络 CBT 结果相当。[114]Olthuis JV, Watt MC, Bailey K, et al. Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database Syst Rev. 2016;(3):CD011565.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011565.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/26968204?tool=bestpractice.com[114]Olthuis JV, Watt MC, Bailey K, et al. Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database Syst Rev. 2016;(3):CD011565.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011565.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/26968204?tool=bestpractice.com [ 
]What are the benefits of cognitive behavioral therapy (with a therapist's support) when delivered over the Internet?https://cochranelibrary.com/cca/doi/10.1002/cca.1355/full显示答案 需要更多随机试验比较网络形式和基于经验的个体和团体项目的长期效果。[115]Abramowitz JS, Moore EL, Braddock AE, et al. Self-help cognitive behavioral therapy with minimal therapist contact for social phobia: a controlled trial. J Behav Ther Exp Psychiatry. 2009 Mar;40(1):98-105.http://www.ncbi.nlm.nih.gov/pubmed/18514614?tool=bestpractice.com[116]Tillfors M, Carlbring P, Furmark T, et al. Treating university students with social phobia and public speaking fears: internet delivered self-help with or without live group exposure sessions. Depress Anxiety. 2008;25(8):708-17.http://www.ncbi.nlm.nih.gov/pubmed/18729147?tool=bestpractice.com[117]Cuijpers P, Marks IM, van Straten A, et al. Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cogn Behav Ther. 2009;38(2):66-82.http://www.ncbi.nlm.nih.gov/pubmed/20183688?tool=bestpractice.com
解释-修正疗法
对威胁的注意偏差被认为与维持社交焦虑相关。研究发现，训练高水平社交焦虑个体将模糊的社会线索解释为良性线索，能够减少对社交威胁线索的注意偏差。[118]Amir N, Bomyea J, Beard C. The effect of single-session interpretation modification on attention bias in socially anxious individuals. J Anxiety Disord. 2010 Mar;24(2):178-82.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815226/http://www.ncbi.nlm.nih.gov/pubmed/19926442?tool=bestpractice.com
虚拟现实暴露疗法
虚拟现实暴露疗法采用先进的计算机技术来帮助创设恐惧线索和场景，如演说情境。初步研究表明虚拟现实疗法可能有效，但仍需要进一步的随机对照试验。[119]Klinger E, Bouchard S, Legeron P, et al. Virtual reality therapy versus cognitive behavioral therapy for social phobia: a preliminary controlled study. Cyberpsychol Behav. 2005 Feb;8(1):76-88.http://www.ncbi.nlm.nih.gov/pubmed/15738695?tool=bestpractice.com
跨诊断方式
不论诊断如何，跨诊断治疗包括采用认知行为的方法来管理焦虑。近期研究支持跨诊断疗法治疗社交焦虑的有效性。[110]Dear BF, Staples LG, Terides MD, et al. Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for social anxiety disorder and comorbid disorders: a randomized controlled trial. J Anxiety Disord. 2016 Aug;42:30-44.http://www.sciencedirect.com/science/article/pii/S0887618516300639http://www.ncbi.nlm.nih.gov/pubmed/27261562?tool=bestpractice.com[120]Norton PJ, Barrera TL. Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: a preliminary randomized controlled noninferiority trial. Depress Anxiety. 2012 Oct;29(10):874-82.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3463777/http://www.ncbi.nlm.nih.gov/pubmed/22767410?tool=bestpractice.com
增强运动
认知行为疗法治疗社交焦虑障碍的症状性结果可以通过增加有氧运动和无氧运动来改善。[121]Jayakody K, Gunadasa S, Hosker C. Exercise for anxiety disorders: systematic review. Br J Sports Med. 2014 Feb;48(3):187-96.http://www.ncbi.nlm.nih.gov/pubmed/23299048?tool=bestpractice.com
