Trajectory and magnitude of response in adults with anxiety disorders: a Bayesian hierarchical modeling meta-analysis of selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and benzodiazepines.

Anxiety antidepressant benzodiazepine placebo selective serotonin reuptake inhibitor serotonin norepinephrine reuptake inhibitor

Journal

CNS spectrums
ISSN: 1092-8529
Titre abrégé: CNS Spectr
Pays: United States
ID NLM: 9702877

Informations de publication

Date de publication:
25 Mar 2024
Historique:
pubmed: 25 3 2024
medline: 25 3 2024
entrez: 25 3 2024
Statut: aheadofprint

Résumé

How the trajectory of response to medication (and placebo response) varies among selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), benzodiazepines and across anxiety disorders is unknown. We performed a meta-analysis using weekly symptom severity data from randomized, parallel-group, placebo-controlled trials of SSRIs, SNRIs, and benzodiazepines in adults with anxiety disorders. Response was modeled for the standardized change in anxiety using Bayesian hierarchical models. Across 122 trials (N=15,760), SSRIs, SNRIs, and benzodiazepines produced significant improvement in anxiety compared to placebo. Benzodiazepines produced faster improvement by the first week of treatment ( Benzodiazepines show early improvement compared to SSRIs and SNRIs. However, by week 8, all treatments yield similar results. Patient characteristics influence the improvement trajectory and magnitude, suggesting potential for personalized medication selection.

Sections du résumé

BACKGROUND BACKGROUND
How the trajectory of response to medication (and placebo response) varies among selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), benzodiazepines and across anxiety disorders is unknown.
METHODS METHODS
We performed a meta-analysis using weekly symptom severity data from randomized, parallel-group, placebo-controlled trials of SSRIs, SNRIs, and benzodiazepines in adults with anxiety disorders. Response was modeled for the standardized change in anxiety using Bayesian hierarchical models.
RESULTS RESULTS
Across 122 trials (N=15,760), SSRIs, SNRIs, and benzodiazepines produced significant improvement in anxiety compared to placebo. Benzodiazepines produced faster improvement by the first week of treatment (
CONCLUSIONS CONCLUSIONS
Benzodiazepines show early improvement compared to SSRIs and SNRIs. However, by week 8, all treatments yield similar results. Patient characteristics influence the improvement trajectory and magnitude, suggesting potential for personalized medication selection.

Identifiants

DOI: 10.1017/S1092852924000142 PMID: 38523533
pubmed: 38523533
doi: 10.1017/S1092852924000142
pii: S1092852924000142
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-10

Auteurs

Eric M Mendez (EM)

Department of Psychiatry & Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.

Jeffrey A Mills (JA)

Department of Economics, Lindner College of Business, University of Cincinnati, Cincinnati, OH, USA.

Vikram Suresh (V)

Department of Economics, Lindner College of Business, University of Cincinnati, Cincinnati, OH, USA.

Julia N Stimpfl (JN)

Department of Psychiatry & Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.

Jeffrey R Strawn (JR)

Department of Psychiatry & Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
Divisions of Child & Adolescent Psychiatry and Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
ORCID: 0000-0002-7526-2641

Classifications MeSH