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

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PSYCHOPHARMACOLOGY
卷 215, 期 1, 页码 1-11

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SPRINGER
DOI: 10.1007/s00213-010-2113-3

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Anxiety; Drug; Social anxiety disorder; Social phobia; Pharmacological treatment; Second-generation antidepressants; Meta-analysis

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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). The aim of the present study is to evaluate the effectiveness of SGA in SAD and to investigate possible differences in their efficacy. 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). 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 a parts per thousand currency sign2) 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). Second-generation antidepressants are efficacious treatment for patients with SAD. However, our results do not suggest differences of efficacy among different drugs.

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