Antidepressants for generalized anxiety disorder (GAD)

Detalhes bibliográficos
Autor(a) principal: Kapczinski, Flávio Pereira
Data de Publicação: 2003
Outros Autores: Souza, Juliano dos Santos, Cunha, Angelo Batista Miralha da, Schmitt, Ricardo Ludwig de Souza
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFRGS
Texto Completo: http://hdl.handle.net/10183/216745
Resumo: Background Pharmacological treatments have been successfully used to treat Generalized Anxiety Disorder (GAD). Benzodiazepine and non benzodiazepine anxiolytics used to be the mainstay for the pharmacological treatment of GAD. However, data emerging over the last two decades have shown that antidepressants may be as effective as anxiolytics in this condition. The use of antidepressants may also be beneficial , because GAD often coexists with major depressive disorder (62% comorbidity) and dysthymia (37%). Objectives To assess the efficacy and acceptability of antidepressants for treating generalized anxiety disorder. Search methods Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register - CCDANCTR (up to May 2002), Anxiety Neurosis (up to May 2002) and Cochrane Controlled Trials Register (CENTRAL/CCTR) (up to May 2002), MEDLINE (1966 to May 2002), LILACS (1982 to May 2002); reference searching; personal communication; conference abstracts and book chapters on the treatment of generalized anxiety disorder. Selection criteria Randomized controlled trials were included. Non randomized studies and those that included patients with both GAD and another Axis I co-morbidity were excluded. Data collection and analysis The data from studies were extracted independently by two reviewers. Relative risks, weighted mean difference and number needed to treat were estimated. People who died or dropped out were regarded as having had no improvement. Main results Antidepressants (imipramine, venlafaxine and paroxetine) were found to be superior to placebo in treating GAD. The calculated NNT for antidepressants inGADis 5.15.Dropout rates did not differ between antidepressants. Only one study presented data on imipramine and trazodone. Imipramine was chosen as the reference drug and, therefore, data on trazodone could not be included in the meta analysis. Only one study was conducted among children and adolescents (Rynn 2000). This showed very promising results of sertraline in children and adolescents with GAD, which warrants replication in larger samples. Authors’ conclusions The available evidence suggests that antidepressants are superior to placebo in treating GAD. There is evidence fromone trial suggesting that paroxetine and imipramine have a similar efficacy and tolerability. There is also evidence from placebo-controlled trials suggesting that these drugs are well tolerated by GAD patients. Further trials of antidepressants for GAD will help to demonstrate which antidepressants should be used for which patients.
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spelling Kapczinski, Flávio PereiraSouza, Juliano dos SantosCunha, Angelo Batista Miralha daSchmitt, Ricardo Ludwig de Souza2020-12-20T04:07:29Z20031469-493Xhttp://hdl.handle.net/10183/216745000385194Background Pharmacological treatments have been successfully used to treat Generalized Anxiety Disorder (GAD). Benzodiazepine and non benzodiazepine anxiolytics used to be the mainstay for the pharmacological treatment of GAD. However, data emerging over the last two decades have shown that antidepressants may be as effective as anxiolytics in this condition. The use of antidepressants may also be beneficial , because GAD often coexists with major depressive disorder (62% comorbidity) and dysthymia (37%). Objectives To assess the efficacy and acceptability of antidepressants for treating generalized anxiety disorder. Search methods Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register - CCDANCTR (up to May 2002), Anxiety Neurosis (up to May 2002) and Cochrane Controlled Trials Register (CENTRAL/CCTR) (up to May 2002), MEDLINE (1966 to May 2002), LILACS (1982 to May 2002); reference searching; personal communication; conference abstracts and book chapters on the treatment of generalized anxiety disorder. Selection criteria Randomized controlled trials were included. Non randomized studies and those that included patients with both GAD and another Axis I co-morbidity were excluded. Data collection and analysis The data from studies were extracted independently by two reviewers. Relative risks, weighted mean difference and number needed to treat were estimated. People who died or dropped out were regarded as having had no improvement. Main results Antidepressants (imipramine, venlafaxine and paroxetine) were found to be superior to placebo in treating GAD. The calculated NNT for antidepressants inGADis 5.15.Dropout rates did not differ between antidepressants. Only one study presented data on imipramine and trazodone. Imipramine was chosen as the reference drug and, therefore, data on trazodone could not be included in the meta analysis. Only one study was conducted among children and adolescents (Rynn 2000). This showed very promising results of sertraline in children and adolescents with GAD, which warrants replication in larger samples. Authors’ conclusions The available evidence suggests that antidepressants are superior to placebo in treating GAD. There is evidence fromone trial suggesting that paroxetine and imipramine have a similar efficacy and tolerability. There is also evidence from placebo-controlled trials suggesting that these drugs are well tolerated by GAD patients. Further trials of antidepressants for GAD will help to demonstrate which antidepressants should be used for which patients.application/pdfengThe Cochrane database of systematic reviews. Chichester. N. 3 (2003) CD003592, 40 p.AntidepressivosTranstornos de ansiedadeAntidepressants for generalized anxiety disorder (GAD)Estrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT000385194.pdf.txt000385194.pdf.txtExtracted Texttext/plain91664http://www.lume.ufrgs.br/bitstream/10183/216745/2/000385194.pdf.txt61642caf0ab47e61def0b1914e91dfacMD52ORIGINAL000385194.pdfTexto completo (inglês)application/pdf295397http://www.lume.ufrgs.br/bitstream/10183/216745/1/000385194.pdf8fc01ab7f44fa7d50d063724292871b6MD5110183/2167452023-09-29 03:39:08.892406oai:www.lume.ufrgs.br:10183/216745Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-09-29T06:39:08Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false
dc.title.pt_BR.fl_str_mv Antidepressants for generalized anxiety disorder (GAD)
title Antidepressants for generalized anxiety disorder (GAD)
spellingShingle Antidepressants for generalized anxiety disorder (GAD)
Kapczinski, Flávio Pereira
Antidepressivos
Transtornos de ansiedade
title_short Antidepressants for generalized anxiety disorder (GAD)
title_full Antidepressants for generalized anxiety disorder (GAD)
title_fullStr Antidepressants for generalized anxiety disorder (GAD)
title_full_unstemmed Antidepressants for generalized anxiety disorder (GAD)
title_sort Antidepressants for generalized anxiety disorder (GAD)
author Kapczinski, Flávio Pereira
author_facet Kapczinski, Flávio Pereira
Souza, Juliano dos Santos
Cunha, Angelo Batista Miralha da
Schmitt, Ricardo Ludwig de Souza
author_role author
author2 Souza, Juliano dos Santos
Cunha, Angelo Batista Miralha da
Schmitt, Ricardo Ludwig de Souza
author2_role author
author
author
dc.contributor.author.fl_str_mv Kapczinski, Flávio Pereira
Souza, Juliano dos Santos
Cunha, Angelo Batista Miralha da
Schmitt, Ricardo Ludwig de Souza
dc.subject.por.fl_str_mv Antidepressivos
Transtornos de ansiedade
topic Antidepressivos
Transtornos de ansiedade
description Background Pharmacological treatments have been successfully used to treat Generalized Anxiety Disorder (GAD). Benzodiazepine and non benzodiazepine anxiolytics used to be the mainstay for the pharmacological treatment of GAD. However, data emerging over the last two decades have shown that antidepressants may be as effective as anxiolytics in this condition. The use of antidepressants may also be beneficial , because GAD often coexists with major depressive disorder (62% comorbidity) and dysthymia (37%). Objectives To assess the efficacy and acceptability of antidepressants for treating generalized anxiety disorder. Search methods Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register - CCDANCTR (up to May 2002), Anxiety Neurosis (up to May 2002) and Cochrane Controlled Trials Register (CENTRAL/CCTR) (up to May 2002), MEDLINE (1966 to May 2002), LILACS (1982 to May 2002); reference searching; personal communication; conference abstracts and book chapters on the treatment of generalized anxiety disorder. Selection criteria Randomized controlled trials were included. Non randomized studies and those that included patients with both GAD and another Axis I co-morbidity were excluded. Data collection and analysis The data from studies were extracted independently by two reviewers. Relative risks, weighted mean difference and number needed to treat were estimated. People who died or dropped out were regarded as having had no improvement. Main results Antidepressants (imipramine, venlafaxine and paroxetine) were found to be superior to placebo in treating GAD. The calculated NNT for antidepressants inGADis 5.15.Dropout rates did not differ between antidepressants. Only one study presented data on imipramine and trazodone. Imipramine was chosen as the reference drug and, therefore, data on trazodone could not be included in the meta analysis. Only one study was conducted among children and adolescents (Rynn 2000). This showed very promising results of sertraline in children and adolescents with GAD, which warrants replication in larger samples. Authors’ conclusions The available evidence suggests that antidepressants are superior to placebo in treating GAD. There is evidence fromone trial suggesting that paroxetine and imipramine have a similar efficacy and tolerability. There is also evidence from placebo-controlled trials suggesting that these drugs are well tolerated by GAD patients. Further trials of antidepressants for GAD will help to demonstrate which antidepressants should be used for which patients.
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dc.relation.ispartof.pt_BR.fl_str_mv The Cochrane database of systematic reviews. Chichester. N. 3 (2003) CD003592, 40 p.
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