Posted by Kon on January 21, 2004, at 1:57:06
In reply to MAOIs v SSRIs v Benzos for Social Phobia, posted by Zabadoo on January 20, 2004, at 8:30:53
>So I was wondering if the following study, which states that all three groups are of equal effect, is just plain wrong?
There was no statistical difference but this review and another one (Federoff, 2001)did find a trend favouring benzos. In the full article, these authors write, "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".
In the end both of these group of authors still recommended SSRIs as first-line therapy for SAD primarily because of the dependency/withdrawl issue with benzos. The weakness with this argument is SSRIs seem to have a similar (if not worse)problem wrt withdrawl/dependency.
I asked my pdoc about this inconsistency. He agreed with much of the above. He even told me that he has never seen anyone with SAD not get some relief with some benzo. This was not the case with SSRIs where some patients did not respond at all to SSRIs. Despite these results in his patients he was still cautious in recommending long-term benzo use for SAD. He felt that long-term use can lead to depression in some patients. He also felt that benzos (especially short-acting ones like xanax) can sometimes lead to true "addiction" (i.e. drug-seeking behaviour)
poster:Kon
thread:303137
URL: http://www.dr-bob.org/babble/20040118/msgs/303565.html