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Efficacy of Nardil v clonazepam for social anxiety » natedog539

Posted by Jedi on May 3, 2007, at 11:26:27

In reply to Re: How common is hypomania on MAOI's? to Jedi, posted by natedog539 on May 3, 2007, at 3:08:29

> Would you say the clonazepam or the nardil is helping out better with the social anxiety. Sorr for all the questions (you just seem so experienced).

Natedog,
I'm sure not an expert. It is hard for me to separate efficacy of the two medications because I have always taken them together. From the published research, I would say that Nardil is better. However it has a lot more side effects. The benzodiazepines are some of the safest and most efficacious medications we have for anxiety; especially as augmentors. (Many MDs would disagree with me on that last statement, especially those from the UK. I'll stand by it.)
Jedi

Abstract:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12900950&query_hl=2&itool=pubmed_docsum

Pharmacological treatment of social anxiety disorder: a meta-analysis.

Blanco C, Schneier FR, Schmidt A, Blanco-Jerez CR, Marshall RD, Sanchez-Lacay A, Liebowitz MR.

Department of Psychiatry of Columbia College of Physicians and Surgeons, Madrid, Spain. cb255@columbia.edu

Placebo-controlled trials have evaluated the efficacy of several medications in the treatment of social anxiety disorder but information regarding their relative efficacy is lacking. ...

There was substantial heterogeneity across trials. The medications with largest effect sizes were phenelzine [effect size, 1.02; 95% Confidence Interval (CI), 0.52-1.52], clonazepam (effect size, 0.97; 95% CI, 0.49-1.45), gabapentin (effect size, 0.78; 95% CI, 0.29-1.27), brofaromine (effect size, 0.66; 95% CI, 0.38-0.94), and the selective serotonin reuptake inhibitors (SSRIs; effect size, 0.65; 95% CI, 0.50-0.81). ...
-------------------------------------------------------------------

Abstract:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12607230&query_hl=2&itool=pubmed_docsum

A review of 19 double-blind placebo-controlled studies in social anxiety disorder (social phobia). Versiani M.

Department of Psychiatry, Federal University of Rio de Janeiro, R. Visconde de Piraja 407 s. 805, Rio de Janeiro, 22410-003, Brazil. versiani@openlink.com.br

Nineteen double-blind placebo-controlled studies on the treatment of Social Anxiety Disorder (Social Phobia) are reviewed. Initial trials yielded a high degree of efficacy for phenelzine, a large difference between drug and placebo and a low rate of placebo response. Controlled studies with RIMAs (moclobemide and brofaromine) yielded more moderate levels of efficacy and more pronounced placebo effects. Results of the Liebowitz Social Anxiety Scale (LSAS) permit a comparison of the outcomes of the different controlled trials. Overall, the reduction in the mean total score with various drugs is inferior to 50%, probably because the chronic nature of the disorder is not amenable to drastic changes in short-term trials. Results with the LSAS and other scales justify a ranking of the efficacy of the drugs: Classical MAOIs > SRIs > RIMAs. Two controlled studies with benzodiazepines (clonazepam and bromazepam) would position them together with the SRIs relative to efficacy but with problems associated with unwanted effects and dependence. Controlled studies with SRIs (paroxetine and fluvoxamine) demonstrated very significant differences from placebo. Paroxetine is the SRI most extensively studied in Social Anxiety Disorder with positive therapeutic results.

PMID: 12607230 [PubMed - indexed for MEDLINE]


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poster:Jedi thread:755025
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