SynthesisEuropean archives of psychiatry and clinical neuroscience2026
Comparative efficacy and acceptability of anxiolytic drugs for the treatment of anxiety disorders: a systematic review and network meta-analysis.
Synthesis in European archives of psychiatry and clinical neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Changes in Anxiety Severity and Acceptability of Venlafaxine in Generalized Anxiety Disorder in the United States: Results From a Real-World Study.Neuropsychiatric disease and treatment · 2026Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnti-anxiety medications' side effects and dependency risks necessitate thorough consideration of their efficacy and acceptability when making treatment decisions.
methodsA systematic review and Network Meta-Analysis (NMA) was conducted using three databases from 1980 to 2020, focusing on adults diagnosed with generalized anxiety disorder (GAD) or any relevant diagnostic classification of anxiety disorder or those for whom Hamilton Anxiety (HAM-A) data is available, and including any comparator (placebo and/or active comparator treatments). The primary outcomes were efficacy (mean difference in change from baseline in HAM-A total score) and acceptability (study discontinuations for any cause). This study is registered with Open Science Framework (OSF) database.
findingsAnalysis of 100 trials involving 28,637 participants showed that most active drugs were more effective than placebo in reducing anxiety. Notably, silexan was the only phytopharmaceutical included in the NMA. Clomipramine had the highest efficacy and vortioxetine the least. However, in terms of acceptability, clomipramine led to the most study discontinuations, while clobazam had the lowest discontinuation rate, indicating that efficacy and acceptability do not always align. Notably, silexan was both highly effective and as acceptable as a placebo. Only four treatments showed fewer adverse events than placebo (diazepam, agomelatine, clobazam, and silexan).
conclusionThis network meta-analysis provides a unique comparison of the efficacy and acceptability of anxiolytics. It represents one of the most comprehensive evidence bases available to guide the first choice of treatment for anxiety disorders in adults.
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Registered trials
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