Question:
How effective is CBT compared to SSRI's (Selective Serotonin Reuptake Inhibitor's) for treating anxiety disorders in adults?
Answer:
Plain language
summary
Most of the research found suggests that CBT and SSRI's have
similar effects in improving symptoms of anxiety. One study
suggests that SSRI's are significantly better than CBT at reducing
frequency of panic attacks in people with Panic Disorder, however
this particular study was of poor quality.
Clinical and research
implications
Overall there was a small amount of moderate quality evidence to
suggest that CBT and SSRIs have similar effects in improving
symptoms of hypochondriasis, anxiety and worry after up to 16 weeks
of treatment in adults with anxiety disorders. However one poor
quality RCT found that SSRIs were better than CBT in reducing the
frequency of panic attacks in adults with panic disorder, with or
without agoraphobia. It recommended that for those with moderate or
severe agoraphobia combined CBT and SSRI is advised but that SSRIs
alone could be used for milder cases.
As most of these RCTs only measured outcomes in the short-term
(up to 16 weeks) further research is needed to evaluate whether the
positive effects of CBT and SSRIs are maintained over a longer time
period. One of the RCTs in older adults aged 60 years or more also
stated that there has been a lack of research into the treatment of
later life anxiety with SSRIs and more research is needed into
other psychological interventions such as reminiscence therapy.
What do guidelines say?
Neither NICE or SIGN guidelines comment on specific research
conducted about CBT vs SSRI's for treating anxiety disorders in
adults. However two NICE guidelines do make recommendations for how
each intervention should be administered for Social or General
anxiety disorders and recommendations on research that should be
conducted on this topic.
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For related NICEguidelines,
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