Augmentation of psychotherapy with d-cycloserine for anxiety disorders

Ipser, Jonathan; Sander, C; Seifan, Alon; Stein, Dan J.

doi:10.1002/14651858.cd007803

Cited by 2 publications

(1 citation statement)

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“…In this review, we did not include a cost-effectiveness analysis, and this may be worth undertaking in the future. Additional work is needed to determine the best approach for people who fail to respond to pharmacotherapy; there are relatively few studies of treatment augmentation (Aarre, 2003;Ipser et al, 2009;Pecknold et al, 1982;Stein et al, 2001;Van Ameringen et al, 1996) or pharmacotherapy switching (Kelsey, 1995). Another research priority revolves around the combined use of pharmacotherapy with psychotherapy and when and if these treatments should be combined or sequenced (Curtiss et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Pharmacological treatments for social anxiety disorder in adults: a systematic review and network meta-analysis

Williams

McCaul

Schwarzer

et al. 2020

Acta Neuropsychiatr.

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AbstractObjective:The aim of this paper was to provide a systematic review and update on the pharmacotherapy of social anxiety disorder (SAD), including the efficacy and tolerability of these agents, the ranking of interventions, and the grading of results by quality of evidence.Methods:The Common Mental Disorder Controlled Trial Register and two trial registries were searched for randomised controlled trials (RCTs) comparing any pharmacological intervention or placebo in the treatment of SAD. We performed a standard pairwise meta-analysis using a random effects model and carried out a network meta-analysis (NMA) using the statistical package, R. Quality of evidence was also assessed.Results:We included 67 RCTs in the review and 21 to 45 interventions in the NMA. Paroxetine was most effective in the reduction of symptom severity as compared to placebo. Superior response to treatment was also observed for paroxetine, brofaromine, bromazepam, clonazepam, escitalopram, fluvoxamine, phenelzine, and sertraline. Higher dropout rates were found for fluvoxamine. Brofaromine, escitalopram, fluvoxamine, paroxetine, pregabalin, sertraline, and venlafaxine performed worse in comparison to placebo for the outcome of dropouts due to adverse events. Olanzapine yielded a relatively high rank for treatment efficacy and buspirone the worse rank for dropouts due to any cause.Conclusion:The differences between drugs and placebo were small, apart from a significant reduction in symptom severity and response for paroxetine. We suggest paroxetine as a first-line treatment of SAD, with the consideration of future research on the drug olanzapine as well as brofaromine, bromazepam, clonazepam, escitalopram, fluvoxamine, phenelzine, and sertraline because we observed a response to treatment.

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