Comparing the efficacy of benzodiazepines and serotonergic anti-depressants for adults with generalized anxiety disorder: A meta-analytic review
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INTRODUCTION: Generalized anxiety disorder (GAD) is a common form of anxiety disorder. Selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and benzodiazepines (BZs) are the most commonly prescribed medications for GAD, but little is known about the relative efficacy of these pharmacological treatments. Areas covered: This study provides a meta-analytic review of the efficacy of these medications in the treatment of adults with GAD. A comprehensive literature search yielded 54 articles reporting 56 unique studies with 12,655 participants treated with either pill placebo (6,191 participants), SSRIs (16 trials, 2,712 participants), SNRIs (17 trials, 2,603 participants), or BZs (23 trials, 1,149 participants). The overall combined effect size was modest to moderate (Hedges' g = 0.37, p < 0.0001). Effect sizes decreased significantly over time. SSRIs (Hedges' g = 0.33) and SNRIs (Hedges' g = 0.36) demonstrated significantly lower effect sizes than BZs (Hedges' g = 0.50). These findings were not due to differences in treatment length or publication year. Expert opinion: The results of this study suggest that the most common forms of pharmacotherapy for adult GAD are moderately effective, with BZs being the most effective drug.
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BDZs demonstrate efficacy for the treatment of GAD.
“In contrast, BDZs demonstrate efficacy for the treatment of GAD (Gomez, Barthel, & Hofmann, 2018) and are still and even increasingly prescribed (Agarwal & Landon, 2019;Bachhuber, Hennessy, Cunningham, & Starrels, 2016).”
From Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders (2019) · cites this paper as Gomez, Barthel, & Hofmann, 2018
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- Authors
- Gomez, A. F., Barthel, A. L., & Hofmann, S. G.
- Affiliations
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
- Boston University (US)
- Corresponding author
- Hofmann, Stefan G.
- ORCID
- Hofmann, Stefan G.
- Venue
- Expert Opinion on Pharmacotherapy
- Publisher
- Informa UK Limited
- Published
- 2018-05-24
- Volume
- 19
- Issue
- 8
- Pages
- 883-894
- ISSN
- 1465-6566 (ISSN-L)
- 1744-7666
- PMC
- PMC6097846
- OpenAlex
- W2804266260
- Cited by
- 125
- References
- 102
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 32 · 2023: 18 · 2022: 11 · 2021: 16 · 2020: 17 · 2019: 9 · 2018: 2
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Expert Opinion on Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R34MH099311)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- generalized anxiety disorder, benzodiazepines, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, pharmacotherapy efficacy, antidepressant comparison, placebo response, adults
- MeSH terms
- Serotonin and Noradrenaline Reuptake Inhibitors, Anxiety Disorders, Benzodiazepines, Humans, Anti-Anxiety Agents, Databases, Factual, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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