Cochrane · systematic review · CD001206
Pharmacotherapy for social anxiety disorder (SAnD)
Williams, T, Hattingh, CJ, Kariuki, CM, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
62
current version
GRADE rated
62
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 33 · 53.2%Low 21 · 33.9%Moderate 8 · 12.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Comparison 1: 5HT1A partial agonists versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 1: 5HT1A partial agonists vs placebo | RR 1 [0.07, 14.55] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Dropouts due to adverse events (acute phase) Comparison 1: 5HT1A partial agonists vs placebo | RR 3 [0.13, 68.26] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS avoidance subscale Comparison 1: 5HT1A partial agonists vs placebo | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
Comparison 2: anticonvulsants/GABAs versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 2: anticonvulsants/GABAs vs placebo | RR 1.6 [1.16, 2.2] | 3 studies · 532 participants | Moderate Downgraded: risk of bias |
Dropouts due to adverse events (acute phase) Comparison 2: anticonvulsants/GABAs vs placebo | RR 2.9 [0.92, 9.14] | 3 studies · 532 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 2: anticonvulsants/GABAs vs placebo | no estimate extracted | 1 study · 69 participants | Low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS avoidance subscale Comparison 2: anticonvulsants/GABAs vs placebo | no estimate extracted | 1 study · 69 participants | Low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS fear subscale Comparison 2: anticonvulsants/GABAs vs placebo | no estimate extracted | 1 study · 69 participants | Low Downgraded: risk of bias, imprecision |
Comparison 3: anticonvulsant levetiracetam versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 3: anticonvulsant levetiracetam vs placebo | RR 0.98 [0.7, 1.37] | 2 studies · 228 participants | Moderate Downgraded: risk of bias |
Dropouts due to adverse events (acute phase) Comparison 3: anticonvulsant levetiracetam vs placebo | RR 2 [0.81, 4.94] | 2 studies · 235 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 3: anticonvulsant levetiracetam vs placebo | no estimate extracted | 2 studies · 228 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS avoidance subscale Comparison 3: anticonvulsant levetiracetam vs placebo | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS fear subscale Comparison 3: anticonvulsant levetiracetam vs placebo | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias, imprecision |
Comparison 4: antipsychotics versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 4: antipsychotics vs placebo | RR 7 [0.45, 108.26] | 1 study · 10 participants | Very low Downgraded: risk of bias, imprecision |
Dropouts due to adverse events (acute phase) Comparison 4: antipsychotics vs placebo | RR 0.71 [0.06, 8.9] | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 4: antipsychotics vs placebo | no estimate extracted | 1 study · 9 participants | Very low Downgraded: risk of bias, imprecision |
Comparison 5: benzodiazepines versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 5: benzodiazepines vs placebo | RR 4.03 [2.45, 6.65] | 2 studies · 132 participants | Low Downgraded: risk of bias, imprecision |
Relapse rate ‐ no. relapsed Comparison 5: benzodiazepines vs placebo | RR 0.12 [0.01, 2.14] | 1 study · 36 participants | Low Downgraded: risk of bias, imprecision |
Dropouts due to adverse events (acute phase) Comparison 5: benzodiazepines vs placebo | RR 1.68 [0.21, 13.13] | 2 studies · 96 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 5: benzodiazepines vs placebo | no estimate extracted | 2 studies · 135 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS avoidance subscale Comparison 5: benzodiazepines vs placebo | no estimate extracted | 1 study · 75 participants | Low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS fear subscale Comparison 5: benzodiazepines vs placebo | no estimate extracted | 1 study · 75 participants | Low Downgraded: risk of bias, imprecision |
Comparison 6: beta‐blockers versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 6: beta‐blockers vs placebo | RR 1.09 [0.63, 1.88] | 2 studies · 97 participants | Very low Downgraded: risk of bias, imprecision |
Comparison 7: MAOIs versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 7: MAOIs vs placebo | RR 2.36 [1.48, 3.75] | 4 studies · 235 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 7: MAOIs vs placebo | no estimate extracted | 4 studies · 218 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS avoidance subscale Comparison 7: MAOIs vs placebo | no estimate extracted | 1 study · 51 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS fear subscale Comparison 7: MAOIs vs placebo | no estimate extracted | 1 study · 51 participants | Very low Downgraded: risk of bias, imprecision |
Clinical Global Impressions scale change item (CGI‐I):no. of responders (long term) Post‐treatment: 6 months Comparison 7: MAOIs vs placebo | RR 1.84 [1.02, 3.33] | 2 studies · 113 participants | Very low Downgraded: risk of bias, imprecision |
Comparison 8: NARIs versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 8: NARIs vs placebo | RR 0.7 [0.19, 2.54] | 1 study · 27 participants | Very low Downgraded: risk of bias, imprecision |
Dropouts due to adverse events (acute phase) Comparison 8: NARIs vs placebo | RR 2.8 [0.12, 63.2] | 1 study · 27 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 8: NARIs vs placebo | no estimate extracted | 1 study · 26 participants | Very low Downgraded: risk of bias, imprecision |
Comparison 9: NaSSAs versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 9: NaSSAs vs placebo | RR 1 [0.28, 3.63] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Dropouts due to adverse events (acute phase) Comparison 9: NaSSAs vs placebo | RR 5 [0.25, 99.95] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 9: NaSSAs vs placebo | no estimate extracted | 2 studies · 126 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS avoidance subscale Comparison 9: NaSSAs vs placebo | no estimate extracted | 1 study · 60 participants | Low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS fear subscale Comparison 9: NaSSAs vs placebo | no estimate extracted | 1 study · 60 participants | Low Downgraded: risk of bias, imprecision |
Comparison 10: RIMAs versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 10: RIMAs vs placebo | RR 1.83 [1.32, 2.55] | 8 studies · 1270 participants | Low Downgraded: risk of bias, inconsistency |
Dropouts due to adverse events (acute phase) Comparison 10: RIMAs vs placebo | RR 1.42 [0.86, 2.34] | 8 studies · 1305 participants | Very low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 10: RIMAs vs placebo | no estimate extracted | 6 studies · 1163 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS avoidance subscale Comparison 10: RIMAs vs placebo | no estimate extracted | 5 studies · 695 participants | Low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS fear subscale Comparison 10: RIMAs vs placebo | no estimate extracted | 6 studies · 724 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Clinical Global Impressions scale change item (CGI‐I): no. of responders (long term) Post‐treatment: 1‐15 months Comparison 10: RIMAs vs placebo | RR 1.5 [1.12, 2] | 1 study · 90 participants | Moderate Downgraded: risk of bias |
Comparison 11: SARIs versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 11: SARIs vs placebo | no estimate extracted | 1 study · 102 participants | Very low Downgraded: risk of bias, imprecision |
Comparison 12: SNRIs versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 12: SNRIs vs placebo | RR 1.3 [0.85, 1.99] | 4 studies · 1173 participants | Low Downgraded: risk of bias, inconsistency |
Dropouts due to adverse events (acute phase) Comparison 12: SNRIs vs placebo | RR 3.23 [2.15, 4.86] | 4 studies · 1213 participants | Moderate Downgraded: risk of bias |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 12: SNRIs vs placebo | no estimate extracted | 3 studies · 902 participants | Moderate Downgraded: risk of bias |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS avoidance subscale Comparison 12: SNRIs vs placebo | no estimate extracted | 1 study · 261 participants | Low Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS fear subscale Comparison 12: SNRIs vs placebo | no estimate extracted | 1 study · 261 participants | Low Downgraded: risk of bias, imprecision |
Comparison 13: SSRIs versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 13: SSRIs vs placebo | RR 1.65 [1.48, 1.85] | 24 studies · 4984 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Relapse rate ‐ no. relapsed Comparison 13: SSRIs vs placebo | RR 0.34 [0.22, 0.5] | 3 studies · 389 participants | Moderate Downgraded: risk of bias |
Dropouts due to adverse events (acute phase) Comparison 13: SSRIs vs placebo | RR 2.59 [1.97, 3.39] | 24 studies · 5131 participants | Low Downgraded: risk of bias, publication bias |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 13: SSRIs vs placebo | no estimate extracted | 14 studies · 1990 participants | Low Downgraded: risk of bias, inconsistency |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS avoidance subscale Comparison 13: SSRIs vs placebo | no estimate extracted | 7 studies · 1173 participants | Low Downgraded: risk of bias, inconsistency |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS fear subscale Comparison 13: SSRIs vs placebo | no estimate extracted | 7 studies · 1173 participants | Low Downgraded: risk of bias, inconsistency |
Clinical Global Impressions scale change item (CGI‐I): no. of responders (long term) Post‐treatment: 1‐4 months Comparison 13: SSRIs vs placebo | RR 1.27 [1.07, 1.51] | 4 studies · 806 participants | Low Downgraded: risk of bias, inconsistency |
Dropouts due to adverse events (long term) Post‐treatment: 1‐4 months Comparison 13: SSRIs vs placebo | RR 1.17 [0.43, 3.18] | 3 studies · 1274 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Comparison 14: GW876008 versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 14: GW876008 vs placebo | RR 0.83 [0.58, 1.19] | 1 study · 250 participants | Moderate Downgraded: risk of bias, imprecision |
Dropouts due to adverse events (acute phase) Comparison 14: GW876008 vs placebo | RR 2.95 [0.67, 13.02] | 1 study · 252 participants | Low Downgraded: risk of bias, imprecision |
Comparison 15: NK1 receptor antagonist GR205171 versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Global Impressions scale change item (CGI‐I or similar): no. of responders (acute phase) Comparison 15: NK1 receptor antagonist GR205171 vs placebo | RR 5 [0.68, 36.66] | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Dropouts due to adverse events (acute phase) Comparison 15: NK1 receptor antagonist GR205171 vs placebo | no estimate extracted | 1 study · 24 participants | Moderate Downgraded: risk of bias, imprecision |
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 15: NK1 receptor antagonist GR205171 vs placebo | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias, imprecision |
Comparison 16: LY686017 versus placebo for social anxiety disorder (SAnD)
Population: adults with SAnD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Reduction of of anxiety symptoms ‐ Clinician‐rated: LSAS total score Comparison 16: LY686017 vs placebo | no estimate extracted | 1 study · 99 participants | Very low Downgraded: risk of bias, imprecision |