Monoamine Oxidase Inhibitors
The earliest placebo-controlled evidence for the efficacy of this therapeutic class was obtained with phenelzine, and its efficacy is well established Concerns about its tolerability and safety, however, make it a difficult choice of first-line therapy.
There are some concerns about the efficacy of moclobemide, a reversible inhibitor of monoamine oxidase-A, in the treatment of SP. Earlier trials by Versiani et al. and The International Multicenter Clinical Trial Group had reported that moclobemide had greater efficacy than placebo, and a European study reported that moclobemide 600 mg/day was effective in controlling the symptoms of SP. However, other studies did not confirm this result. Brofaromine has also been used in social phobia with a significantly better response than placebo, but this drug is not commercially available.