title: Second-generation antidepressants in social anxiety disorder: meta-analysis of controlled clinical trials.
abstract: BACKGROUND
  A growing number of controlled clinical trials suggest that different second-generation antidepressants (SGA) may be effective in the treatment of social anxiety disorder (SAD).
  
  
  OBJECTIVE
  The aim of the present study is to evaluate the effectiveness of SGA in SAD and to investigate possible differences in their efficacy.
  
  
  METHODS
  We performed a systematic review and meta-analysis of all double-blind, randomized, controlled clinical trials involving second-generation antidepressants in adult patients with SAD published on PubMed/MEDLINE, PsycINFO, and Current Controlled Trials databases until July 2009. Our analyses were based on changes in Liebowitz Social Anxiety Scale (LSAS), Clinical Global Impression (CGI), and standardized mean difference (SMD).
  
  
  RESULTS
  Twenty-seven controlled clinical trials, comprising ten different SGA, were selected. When comparing the reduction of LSAS scores, the group receiving active drugs showed a significantly greater reduction compared to those observed in the placebo group [pooled weighted mean -11.9 (IC 95% -14.5 to -9.4)]. The combined relative risk (RR) for the different drugs revealed a 62% increase in treatment response (final CGI ≤2) for those using SGAs, compared to those receiving placebo [RR 1.62 (95% CI 1.44-1.81)]. The combined SMD for the SGAs was -0.43 (IC 95% -0.49 to -0.37).
  
  
  CONCLUSIONS
  Second-generation antidepressants are efficacious treatment for patients with SAD. However, our results do not suggest differences of efficacy among different drugs.
authors.affiliation: Programa de Ansiedade e Depressão, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Niterói, Rio de Janeiro, Brazil.
authors.forename: Gabriela Bezerra
authors.initials: GB
authors.lastname: de Menezes
authors.forename: Evandro Silva Freire
authors.initials: ES
authors.lastname: Coutinho
authors.forename: Leonardo F
authors.initials: LF
authors.lastname: Fontenelle
authors.forename: Paula
authors.initials: P
authors.lastname: Vigne
authors.forename: Ivan
authors.initials: I
authors.lastname: Figueira
authors.forename: Márcio
authors.initials: M
authors.lastname: Versiani
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D010698:Phobic Disorders / Q000188:drug therapy / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D012919:Social Behavior
chemical_list: D018687:Antidepressive Agents, Second-Generation