Titre du document / Document title

Pharmacological treatment of social anxiety disorder: A meta-analysis

Auteur(s) / Author(s)

BLANCO Carlos ; SCHNEIER Franklin R. ; SCHMIDT Andrew ; BLANCO-JEREZ Carmen-Rosa ; MARSHALL Randall D. ; SANCHEZ-LACAY Arturo ; LIEBOWITZ Michael R. ;

Résumé / Abstract

Placebo-controlled trials have evaluated the efficacy of several medications in the treatment of social anxiety disorder but information regarding their relative efficacy is lacking. We compared the efficacy of medications systematically studied for the treatment of social anxiety disorder using meta-analytic techniques. The methodology included a database search of articles published betueen January 1980 and June 2001 and manual searches of bibliographies in published manuscripts. Trials were included if they reported outcome data on the Liebowitz Social Anxiety Scale (LSAS) or a categorical measure of responder status. Data were extracted independently by two authors. The Q statistic was used to assess homogeneity across trials. All analyses were conducted using intent-to-treat data. There was substantial heterogeneity across trials. The medications with largest effect sizes were phenelzine [effect size, 1.02; 95% Confidence Interval (CI), 0.52-1.52], clonazepam (effect size, .97; 95% CI, 0.49-1.45), gabapentin (effect size, .78; 95% CI, 0.29-1.27), brofaromine (effect size, .66; 95% CI, 0.38-0.94), and the selective serotonin reuptake inhibitors (SSRIs; effect size, .65; 95% CI, 0.50-0.81). There were no statistically significant differences between medications or medication groups. However, formal methods of interim monitoring adapted for meta-analyses suggested strongest evidence of efficacy for SSRIs and brofaromine. Several medications are efficacious for the treatment of social anxiety disorder. The stability of the SSRI effect size estimate in conjunction with other evidence for safety and tolerability and their ability to treat comorbid conditions supports the use of SSRIs as the first-line treatment. Direct comparisons of SSRIs vs. other promising medications deserve consideration.

Revue / Journal Title

Depression and anxiety   ISSN 1091-4269   CODEN DEANF5 

Source / Source

2003, vol. 18, n^o1, pp. 29-40 [12 page(s) (article)]

Langue / Language

Anglais

Editeur / Publisher

Wiley-Liss, New York, NY, ETATS-UNIS  (1996) (Revue)

Localisation / Location

INIST-CNRS, Cote INIST : 26135, 35400011221026.0040