A new review from the Cochrane Database of Systematic Reviews confirms that antidepressants can effectively reduce symptoms of generalized anxiety disorder (GAD) in clinical trials. However, there is limited data on their long-term effects, leaving questions about their continued use over time.
GAD is a common mental health condition that affects millions of people worldwide. It causes excessive worry about daily life, making it difficult for individuals to relax or focus.
Many health organizations, including the UK’s National Institute for Health and Care Excellence (NICE), recommend antidepressants—especially selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)—as a standard treatment for GAD.
Despite these recommendations, some healthcare professionals and patients remain hesitant about using antidepressants for anxiety. One reason is the common misconception that these medications are only for depression. Additionally, the term “antidepressant” carries a stigma, leading some people to avoid them even when they could be beneficial.
Findings from the Review
To better understand how well antidepressants work for GAD, researchers analyzed 37 randomized controlled trials involving more than 12,000 participants. The studies were conducted mainly in high-income countries, such as the United States and several European nations.
The trials included adults of both sexes, though about 60% of participants were women—reflecting the higher prevalence of GAD among women.
The results showed that antidepressants were significantly more effective than a placebo in reducing anxiety symptoms. People taking antidepressants had a 41% higher response rate compared to those given a placebo. Importantly, the review also found that dropout rates were similar between the two groups, suggesting that antidepressants are generally well-tolerated.
Senior author Dr. Giuseppe Guaiana, Associate Professor of Psychiatry at Western University, emphasized the effectiveness of antidepressants in controlled trial settings. “For people with generalized anxiety disorder and no other conditions, we have good evidence that antidepressants lead to meaningful improvements over one to three months,” he said.
However, real-world cases are often more complex. Many people with GAD also have other mental health conditions, such as depression or panic disorder. The review did not provide enough evidence to determine how well antidepressants work in these cases.
Dr. Guaiana noted that future research should focus on how different treatments affect patients with multiple conditions, as this is more reflective of everyday clinical practice.
A Gap in Long-Term Research
One major limitation of the review is the lack of long-term data. Most of the included trials lasted between four and 12 weeks, meaning there is little information on what happens when people take antidepressants for extended periods.
“We don’t have enough information on the potential long-term benefits and harms of antidepressants, even though people often take them for years,” said first author Katarina Kopcalic. She highlighted the need for future studies to explore the long-term effects of these medications, especially since many patients remain on them indefinitely.
What This Means for Patients
Despite these limitations, the review reinforces the idea that antidepressants are effective in managing GAD, particularly for those who do not respond well to therapy or other non-drug treatments.
However, patients and healthcare providers should be aware that more research is needed to fully understand the long-term impact of these medications.
For now, antidepressants remain a valuable option for treating anxiety, but decisions about their use should be made carefully, considering both their benefits and the uncertainties surrounding long-term use.
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The research findings can be found in Cochrane Database of Systematic Reviews.
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