Second-generation antidepressants in social anxiety disorder: meta-analysis of controlled clinical trials.

Abstract

RATIONALE:

A growing number of controlled clinical trials suggest that different second-generation antidepressants (SGA) may be effective in the treatment of social anxiety disorder (SAD).

OBJECTIVES:

The aim of the present study is to evaluate the effectiveness of SGA in SAD and to investigate possible differences in their efficacy.

METHODS:

We performed a systematic review and meta-analysis of all double-blind, randomized, controlled clinical trials involving second-generation antidepressants in adult patients with SAD published on PubMed/MEDLINE, PsycINFO, and Current Controlled Trials databases until July 2009. Our analyses were based on changes in Liebowitz Social Anxiety Scale (LSAS), Clinical Global Impression (CGI), and standardized mean difference (SMD).

RESULTS:

Twenty-seven controlled clinical trials, comprising ten different SGA, were selected. When comparing the reduction of LSAS scores, the group receiving active drugs showed a significantly greater reduction compared to those observed in the placebo group [pooled weighted mean -11.9 (IC 95% -14.5 to -9.4)]. The combined relative risk (RR) for the different drugs revealed a 62% increase in treatment response (final CGI ≤2) for those using SGAs, compared to those receiving placebo [RR 1.62 (95% CI 1.44-1.81)]. The combined SMD for the SGAs was -0.43 (IC 95% -0.49 to -0.37).

CONCLUSION:

Second-generation antidepressants are efficacious treatment for patients with SAD. However, our results do not suggest differences of efficacy among different drugs.

• Authors: Gabriela Bezerra de Menezes, Evandro Silva Freire Coutinho, Leonardo F Fontenelle, Paula Vigne, Ivan Figueira, Márcio Versiani
• Journal: Psychopharmacology (Psychopharmacology (Berl)) Vol. 215 Issue 1 Pg. 1-11 (May 2011) ISSN: 1432-2072 [Electronic] Germany
• PMID: 21181129 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Antidepressive Agents, Second-Generation

Topics

• Antidepressive Agents, Second-Generation (adverse effects, therapeutic use)
• Anxiety Disorders (drug therapy, psychology)
• Humans
• Phobic Disorders (drug therapy, psychology)
• Psychiatric Status Rating Scales
• Randomized Controlled Trials as Topic
• Social Behavior