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A new Cochrane review has confirmed that antidepressants are effective in reducing symptoms of generalized anxiety disorder (GAD), though questions remain about their long-term effects. The review, published in the Cochrane Database of Systematic Reviews, analyzed data from 37 randomized controlled trials involving over 12,000 participants.
GAD, characterized by persistent worry about everyday issues, affects millions globally. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are widely recommended for managing GAD. These medications are endorsed by national bodies like the UK’s National Institute for Health and Care Excellence.
Despite their widespread use, misconceptions persist about antidepressants, with many people unaware that these medications have broader applications beyond treating depression. For some, the term “antidepressant” also carries a stigma.
The review examined trials conducted primarily in high-income countries, including the USA and various European nations. The majority of participants were women (~60%), reflecting the higher clinical prevalence of GAD among females. The study found that antidepressants were 41% more effective than placebos in reducing anxiety symptoms, with a similar tolerance rate between the two groups, as dropout rates were comparable.
Dr. Giuseppe Guaiana, senior author of the review and Associate Professor of Psychiatry at Western University, stated, “This research shows that antidepressants are highly effective at treating GAD, at least in the specific circumstances seen in trials. However, we don’t have enough evidence to determine how they perform in patients with GAD alongside other mental health conditions, which is much more common in clinical practice.”
The review also highlighted a significant gap in the existing research: the lack of long-term follow-up. Most trials in the review lasted between four to 12 weeks, leaving questions about the potential long-term benefits and risks of antidepressants. Katarina Kopcalic, first author of the review, emphasized the need for further investigation into the effects of prolonged use, as many individuals take antidepressants for extended periods.
Despite these gaps, the review reinforces the effectiveness of antidepressants for managing GAD, particularly for patients who do not respond to non-pharmacological treatments. However, experts agree that further, independent research is crucial to better understand the long-term impact of these medications, especially for individuals with multiple conditions.
Disclaimer: The findings of this review are based on studies conducted under trial conditions and do not necessarily reflect real-world outcomes. Future research is needed to assess the long-term safety and efficacy of antidepressants, particularly for patients with multiple mental health conditions.
