Antidepressants for generalized anxiety disorder (GAD)

In the past, people with generalized anxiety disorder (GAD) were usually treated with drugs designed to reduce anxiety (called anxiolytics). There is growing evidence that drugs used to treat depression (antidepressants) may also be helpful for people with GAD. We therefore reviewed clinical trials of the use of antidepressants in GAD . Fifteen published trials were included. Of these trials, eight used recognized methods for diagnosing GAD and gave useful data (Rickels 1993; Rocca 1997; Davidson 1999 a; Gelenberg 2000, Rickels 2000 b, Hackett 1999, Pollack 2001, Rynn 2000). Six trials were excluded: two trials were open studies, without a control group (Hedges 1996; Wingerson 1992); two included patients with GAD plus other types of mental illness (Johnstone 1980 a; Lipman 1986); one study included patients who were stopping long term benzodiazepine therapy (Rickels 2000 a). One study presented early data for an already included study (Hackett 1999). We are waiting for further data for one study (Hoehn-Saric 1988). One study involved children and adolescents with GAD (Rynn 2000) and its results were reviewed separately. Our review showed that antidepressants were better than placebo (dummy treament) for treating GAD and were well tolerated. We did not find evidence to conclude whether some types of antidepressant are better than others. Overall, about 5 people need to be treated in order for one person with GAD to benefit. The single study using antidepressants in children and adolescents with GAD also showed very promising results.