Second generation antidepressants all equally effective in treating social anxiety disorder, according to new systematic review

Antidepressants for anxiety

With a lifetime prevalence of about 12% and a 12-month prevalence of around 4%, social anxiety disorder is the most prevalent anxiety disorder and one of the most common psychiatric conditions.

This systematic review conducted by researchers from the Federal University of Rio de Janeiro in Brazil, aimed to assess the effectiveness of different second generation antidepressants in the treatment of social anxiety disorder.

The reviewers searched Medline, PsycInfo and the Current Controlled Trials database to find double-blind randomised controlled trials. They analysed the data using the Liebowitz Social Anxiety Scale (LSAS), Clinical Global Impression (CGI), and standardised mean difference (SMD).

27 studies were included in the meta-analysis and 10 different antidepressants were covered by the trials.

Here are the results of the review:

  • When comparing the reduction of Liebowitz Social Anxiety Scale 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 second generation antidepressants, compared to those receiving placebo [RR 1.62 (95% CI 1.44-1.81)]
  • The combined standardised mean difference for the second generation antidepressants was -0.43 (IC 95% -0.49 to -0.37).

The authors concluded:

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

de Menezes GB, Coutinho ES, Fontenelle LF, Vigne P, Figueira I, Versiani M. Second-generation antidepressants in social anxiety disorder: meta-analysis of controlled clinical trials. Psychopharmacology (Berl). 2011 May;215(1):1-11. Epub 2010 Dec 22. [PubMed abstract]

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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