Antidepressants for Anxiety: Proven Effective for Generalized Anxiety Disorder
By Pauline Anderson | February 07, 2025
A new Cochrane review confirms that antidepressants for anxiety, particularly SSRIs and SNRIs, are more effective than placebo in treating Generalized Anxiety Disorder (GAD). Additionally, dropout rates between antidepressants and placebo groups were comparable. However, researchers emphasize the need for more data on long-term use.
✅ Meta Description
New Cochrane review confirms antidepressants are effective for Generalized Anxiety Disorder, with short-term benefits outweighing placebo. Learn more here.
What Is Generalized Anxiety Disorder?
Generalized Anxiety Disorder (GAD) affects about 5.1% of U.S. adults. It causes persistent, excessive worry about everyday matters, often accompanied by physical symptoms like muscle tension, nausea, and trembling. Women are twice as likely to be diagnosed compared to men. According to the National Institute of Mental Health (NIMH), GAD also disproportionately affects people with low socioeconomic status or those who are widowed, separated, or divorced.
Current Treatment Options
GAD treatment typically includes:
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Cognitive behavioral therapy (CBT)
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Applied relaxation techniques
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Medications, including benzodiazepines and antidepressants
Most treatment guidelines recommend SSRIs and SNRIs as first-line therapies. While benzodiazepines are effective, their addictive potential makes antidepressants for anxiety a safer long-term option.
New Evidence from Cochrane Review
A team led by Katarina Kopcalic, MSc (Western University, Ontario), conducted a large-scale systematic review, recently published in the Cochrane Database of Systematic Reviews. They analyzed 37 randomized controlled trials (RCTs) involving 12,226 participants.
Key findings:
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Antidepressants were 41% more effective than placebo in achieving treatment response (defined as ≥ 50% reduction on the Hamilton Anxiety Rating Scale).
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Dropout rates were similar between groups.
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Fewer participants dropped out due to lack of efficacy in the antidepressant group.
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However, adverse effects were more common in the antidepressant group, especially drowsiness and gastrointestinal issues.
Suggested Image: A visual comparison of treatment response rates between antidepressants and placebo in GAD patients.
What About Long-Term Use?
The review showed strong short-term benefits but lacked data on long-term safety. Kopcalic emphasized the importance of exploring how antidepressants affect people who use them for years — a common scenario in clinical practice.
“We don’t have enough information on the long-term benefits and harms of antidepressants,” Kopcalic noted in a press release.
Expert Reactions: Support and Caution
Two respected psychiatrists offered perspectives through the Science Media Centre:
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Dr. Katharina Domschke, University of Freiburg, praised the study as a “robust and methodologically sound” analysis that strengthens trust in pharmacologic treatment for GAD.
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Dr. Peter Tyrer, Imperial College London, called the evidence “unequivocal” for short-term benefits. However, he raised concerns about long-term use, potential withdrawal, and the shift in adverse effects from benzodiazepines to antidepressants.
Limitations of the Review
Despite its strengths, the review had some gaps:
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It didn’t include less common antidepressants, like MAOIs or norepinephrine-dopamine reuptake inhibitors.
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Many outcomes — including suicide risk, falls, and withdrawal symptoms — lacked enough data for analysis.
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The population may not reflect real-world patients with multiple comorbidities, limiting the generalizability of the findings.
Final Thoughts
The evidence is clear: antidepressants for anxiety, particularly in the short term, offer significant benefits for those struggling with Generalized Anxiety Disorder. However, the long-term safety profile remains uncertain. Patients and providers must weigh the risks and benefits carefully, especially for extended treatment plans.
Internal Link Suggestion: Learn more about how CBT compares to medication for anxiety.