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Review: limited evidence for use of second-generation antipsychotics in anxiety disorders

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Question

Question: Are second-generation antipsychotics (SGAs) effective treatments for anxiety disorders?

Outcomes: Primary outcome: treatment response defined variably; number of patients with at least a 50% reduction from baseline score on a condition relevant scale: the Hamilton Anxiety Scale for generalised anxiety disorder (GAD), the Panic Disorder Severity Scale or the Sheehan Panic Anxiety Scale–Patient for panic disorder, the Brief Social Phobia Scale or the Liebowitz Social Anxiety Scale for social phobia or a Clinical Global Impressions–Improvement (CGI-I) score of 1 or 2. Any definition of response from the authors was also accepted. Secondary outcomes: remission, relapse, anxiety symptoms, discontinuations and adverse events.

Methods

Design: Systematic review and meta analysis.

Data sources: Cochrane Depression, Anxiety and Neurosis Group's controlled trials registers up to July 2010 (contains updated weekly searches of MEDLINE (starting from 1966), EMBASE (from 1980) and PsycINFO (from 1974)). Additional searches included drug company websites, hand searching of key journals, conference proceedings and non-Cochrane systematic reviews and meta-analyses. International trials registers were searched through the WHO's trial portal (ICTRP).

Study selection and analysis: Randomised controlled trials (RCTs) comparing SGA drugs with placebo, benzodiazepines, pregabalin or antidepressants. …

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