Berney Patricia, Halperin Demian, Tango Rodrigo, Daeniker-Dayer Isabelle, Schulz Pierre
Clinical Psychopharmacology Unit, Geneva University Hospitals, Belle-Idée, Geneva, Switzerland.
Psychopharmacol Bull. 2008;41(3):39-47.
We performed a systematic review of controlled trials on anxiety disorders treatment (generalized anxiety disorder, panic disorder, social phobia and post-traumatic stress disorder) published from 1980 to 2006, and identified trials comparing the efficacy of benzodiazepines (BZD) with that of antidepressants, in particular comparisons between BZD and newer antidepressants. Among 969 publications, 274 double-blind randomized controlled studies remained after using our exclusion criteria. These studies comprised altogether 439 comparisons. There were in total 23 comparisons of antidepressants versus BZD. Among these, 22 compared the efficacy of older antidepressants versus BZD, whereas only 1 concerned the comparison of a newer antidepressant versus BZD. It showed comparable efficacy between venlafaxine and diazepam in the treatment of generalized anxiety disorder. Our study shows that the major change of prescribing pattern from BZD to newer antidepressants in anxiety disorders has occurred in absence of comparative data of high level of proof.
我们对1980年至2006年发表的关于焦虑症治疗（广泛性焦虑症、恐慌症、社交恐惧症和创伤后应激障碍）的对照试验进行了系统评价，并确定了比较苯二氮䓬类药物（BZD）与抗抑郁药疗效的试验，特别是BZD与新型抗抑郁药之间的比较。在969篇出版物中，使用我们的排除标准后，剩下274项双盲随机对照研究。这些研究总共包括439项比较。抗抑郁药与BZD之间总共有23项比较。其中，22项比较了旧型抗抑郁药与BZD的疗效，而只有1项涉及新型抗抑郁药与BZD的比较。结果显示，文拉法辛和地西泮在治疗广泛性焦虑症方面疗效相当。我们的研究表明，在缺乏高水平证据的比较数据的情况下，焦虑症的处方模式已从BZD转向新型抗抑郁药。
