Cochrane Review Shows Antidepressants Reduce Anxiety, But Long-Term Effects Remain Unclear
A new Cochrane review confirms that antidepressants effectively reduce symptoms of generalized anxiety disorder (GAD) under trial conditions, although there is limited data on long-term usage.
The review analyzed 37 randomized controlled trials with over 12,000 participants, comparing antidepressants to a placebo. Most trials recruited adults of both sexes. In most cases, there were slightly more female participants (~60%) which reflects the clinical prevalence of generalized anxiety disorder.
Results showed that antidepressants were more effective than placebo in reducing anxiety symptoms, with a 41% higher response rate among those taking the medication compared to those taking a placebo. The review found no significant difference in dropout rates between those taking antidepressants and those taking a placebo, indicating that these medications are generally well-tolerated.
The review also highlights the lack of data on the long-term effects of antidepressants. Most included trials lasted between 4 to 12 weeks, with no long-term follow-up.
"The research shows that antidepressants are highly effective at treating GAD, at least in the specific circumstances seen in trials,” says senior author Dr Giuseppe Guaiana, Associate Professor of Psychiatry at the Schulich School of Medicine & Dentistry, Western University, and Chief of Psychiatry at St Thomas Elgin General Hospital. “For people with Generalized Anxiety Disorder and no other conditions, we have good evidence that antidepressants lead to clinically meaningful improvements over a one- to three-month period compared to placebo.
“We don’t have enough evidence to say how effective they may be in patients with GAD alongside other mental health conditions, which is much more common in clinical practice. Most of the patients I see with GAD also have other mental health conditions, so future trials should investigate the effects of different treatment strategies on patients with multiple conditions."
Reference: Kopcalic K, Arcaro J, Pinto A, Ali S, Barbui C, Curatoli C, Martin J, Guaiana G. Antidepressants versus placebo for generalised anxiety disorder (GAD). Cochrane Database of Systematic Reviews 2025, Issue 1. Art. No.: CD012942. DOI: 10.1002/14651858.CD012942.pub2. Accessed 30 January 2025.
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