Antidepressants versus placebo for generalized anxiety disorder: A systematic review and meta-analysis
Abstract
Objectives: To assess the efficacy and acceptability of antidepressants compared to placebo among adults with a primary diagnosis of generalized anxiety disorder (GAD). Methods: Five electronic databases and 2 trial registries were searched to identify studies for inclusion. The risk of bias version 1 tool was used to assess the risk of bias. A random-effects meta-analysis was conducted using RevMan web. Results were presented using forest plots. Results: 38 studies (12,570 participants) were included. Very low-quality evidence showed a benefit for antidepressants over placebo in the rate of treatment response (RR, 1.39: 95% CI: 1.27, 1.52) and no differences in acceptability (RR, 1.02: 95% CI: 0.92, 1.12). These results were consistent across different classes of antidepressants. Conclusion: Higher quality of evidence is needed. Future studies should be more transparent with their methodology and outcome reporting and future reviews may include patients with comorbidities and explore other sources of heterogeneity.