Posted by Kon on January 2, 2004, at 7:50:53
In reply to how can a 50 years old medicine be the best for SP, posted by Tepiaca on January 2, 2004, at 0:24:19
> its unbelieveable how a 50 years old medicine -NARDIL- is still the best treatment in the market to combat SP.
I think this is debatable. While there is no question that Nardil is one of the more effective drugs for SP, the drug which has demonstrated the largest improvement score in SP is not Nardil (Phenelzine) but a benzo (particularly clonazepam). Two different meta-analysis came to this conclusion (see Federoff and Taylor, 2001) and the most recent review in November of this year (Blanco, 2003).
Even as a group the benzos tended to score higher (but not significantly) than both the SSRIs and MAOIs such as Nardil . This was the case for both self-reported and therapist reported measures of anxiety reduction. From the Blanco (2003) review:
"Our analysis found that clonazepam, based on a single study, had the largest mean effect size of all medications. The effect sizes of SSRIs and phenelzine were similar to each other and numerically (but not statistically) smaller than those of clonazepam."
Wrt Nardil:
"Until relatively recently, phenelzine was considered the gold standard in the treatment of SAD. However, results from the meta-analyses suggest that its efficacy is not superior to that of the SSRIs or clonazepam, although it has never been directly compared to those medications."
Summary of results the Blanco (2003)review:
Effect size based on Liebowitz Social Anxiety scale (higher the number the > the reduction in anxiety):
Benzos-1.54
Nardil-1.02
SSRIs-0.65
Effect size based on Clinical Global Impression Scale:Benzos-16.61
Nardil-5.53
SSRIs-4.1The Federoff (2001) had similar results with benzos tending to be somewhat better than SSRIs ad MAOIs.
poster:Kon
thread:295600
URL: http://www.dr-bob.org/babble/20031231/msgs/295656.html