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Comparative efficacy and acceptability of first-line drugs for the acute treatment of generalized anxiety disorder in adults: A network meta-analysis
Hairong He1,2; Yutao Xiang3; Fengjie Gao4; Ling Bai1; Fan Gao1; Yajuan Fan4; Jun Lyu1; Xiancang Ma4,5,6
2019-11
Source PublicationJOURNAL OF PSYCHIATRIC RESEARCH
ISSN0022-3956
Volume118Pages:21-30
AbstractThe guide recommends SSRI and SNRI drugs as first-line treatments for generalized anxiety disorder (GAD). Therefore, we aimed to update the evidence using network meta-analysis by comparing the efficacy and acceptability of first-line drugs. The relevant electronic databases were searched for placebo-controlled and head-to-head trials of 11 drugs used for the acute treatment of adults with GAD from 1980 up to January 1, 2019. Data on demographics, clinical, and treatment information were extracted from each eligible study. The primary outcomes were efficacy (quantified as the change in the total score on the Hamilton Anxiety Scale from baseline) and acceptability (quantified as treatment discontinuations due to any cause). Overall, the data on 41 RCTs were sufficient or appropriate for inclusion. In terms of efficacy, all of the drugs except fluoxetine and vortioxetine were more effective than placebo, with the weighted mean difference of the Hamilton Anxiety Scale score ranging between −3.2 (95% credible interval [CrI] = −4.2 to −2.2) for escitalopram and −1·8 (95% CrI = −3.1 to −0.55) for vilazodone. For acceptability, only vilazodone (OR = 1.7, 95% CrI = 1.1 to 2.7) were worse than placebo, others did not show significant differences from placebo. In head-to-head comparisons, vortioxetine showed better acceptability and tolerability but worse efficacy and response rate. In conclusion, most drugs are more effective than placebo, and there are few significant differences between the active drugs and placebo on acceptability. Overall, duloxetine and escitalopram showed better efficacy while vortioxetine showed better acceptability.
KeywordNetwork Meta-analysis Generalized Anxiety Disorder First-line Treatment Drugs
DOI10.1016/j.jpsychires.2019.08.009
Indexed BySCI
Language英语
WOS Research AreaPsychiatry
WOS SubjectPsychiatry
WOS IDWOS:000488143200006
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Cited Times [WOS]:1   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionFaculty of Health Sciences
Affiliation1.Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
2.School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
3.Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
4.Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
5.Clinical Research Center for Mental Disease of Shaanxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
6.Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
Recommended Citation
GB/T 7714
Hairong He,Yutao Xiang,Fengjie Gao,et al. Comparative efficacy and acceptability of first-line drugs for the acute treatment of generalized anxiety disorder in adults: A network meta-analysis[J]. JOURNAL OF PSYCHIATRIC RESEARCH,2019,118:21-30.
APA Hairong He.,Yutao Xiang.,Fengjie Gao.,Ling Bai.,Fan Gao.,...&Xiancang Ma.(2019).Comparative efficacy and acceptability of first-line drugs for the acute treatment of generalized anxiety disorder in adults: A network meta-analysis.JOURNAL OF PSYCHIATRIC RESEARCH,118,21-30.
MLA Hairong He,et al."Comparative efficacy and acceptability of first-line drugs for the acute treatment of generalized anxiety disorder in adults: A network meta-analysis".JOURNAL OF PSYCHIATRIC RESEARCH 118(2019):21-30.
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