Cochrane Database Syst Rev

Growing evidence supports antidepressants for generalized anxiety disorder

February 3, 2025

This review strengthens the evidence that antidepressants are more effective than placebo for treating generalized anxiety disorder (GAD). The review also highlights gaps in the literature, suggesting that future research should improve transparency, include participants with comorbidities, and explore other sources of variability.

Study details: A review of 37 RCTs with 12,226 participants focused on adults with moderate to severe GAD without serious medical comorbidities. Review authors conducted the search in October 2022 across multiple databases and data were independently extracted and assessed for bias using Cochrane methods. Studies on psychotherapies and regular benzodiazepine use were excluded.

Results: Among patients with moderate to severe GAD, antidepressants demonstrated a significant benefit over placebo in reducing Hamilton Anxiety Rating Scale (HAM-A) scores by at least 50% (risk ratio, 1.41, 95% confidence interval, 1.29-1.55). Treatment duration ranged from 4 to 28 weeks. There was no significant difference in overall dropout rates between antidepressants and placebo. Fewer participants discontinued due to lack of efficacy in the antidepressant group vs. the placebo group, while more dropped out due to adverse effects. The findings were consistent across different classes of antidepressants.

Source:

Kopcalic K, et al. (2025, January 30). Cochrane Database Syst Rev. Antidepressants versus placebo for generalised anxiety disorder (GAD). https://pubmed.ncbi.nlm.nih.gov/39880377/