With a lifetime prevalence of about 12% and a 12-month prevalence of around 4%, social anxiety disorder is the most prevalent anxiety disorder and one of the most common psychiatric conditions.

This systematic review conducted by researchers from the Federal University of Rio de Janeiro in Brazil, aimed to assess the effectiveness of different second generation antidepressants in the treatment of social anxiety disorder.

The reviewers searched Medline, PsycInfo and the Current Controlled Trials database to find double-blind randomised controlled trials. They analysed the data using the Liebowitz Social Anxiety Scale (LSAS), Clinical Global Impression (CGI), and standardised mean difference (SMD).

27 studies were included in the meta-analysis and 10 different antidepressants were covered by the trials.

Here are the results of the review:

• When comparing the reduction of Liebowitz Social Anxiety Scale scores, the group receiving active drugs showed a significantly greater reduction compared to those observed in the placebo group [pooled weighted mean -11.9 (IC 95% -14.5 to -9.4)]
• The combined relative risk (RR) for the different drugs revealed a 62% increase in treatment response (final CGI ≤2) for those using second generation antidepressants, compared to those receiving placebo [RR 1.62 (95% CI 1.44-1.81)]
• The combined standardised mean difference for the second generation antidepressants was -0.43 (IC 95% -0.49 to -0.37).

The authors concluded:

Second-generation antidepressants are efficacious treatment for patients with social anxiety disorder. However, our results do not suggest differences of efficacy among different drugs.

de Menezes GB, Coutinho ES, Fontenelle LF, Vigne P, Figueira I, Versiani M. Second-generation antidepressants in social anxiety disorder: meta-analysis of controlled clinical trials. Psychopharmacology (Berl). 2011 May;215(1):1-11. Epub 2010 Dec 22. [PubMed abstract]