1.6Venlafaxine vs Placebo for GAD

Quality assessmentSummary of findingsImportance
No of patientsEffectQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsVenlafaxinePlaceboRelative (95% CI)Absolute
HAM-A (Better indicated by lower values)
5randomised trialsno serious limitationsserious1no serious indirectnessno serious imprecisionnone595582-MD 3.16 lower (4.81 to 1.51 lower)⊕⊕⊕○
MODERATE
Non-response
8randomised trialsno serious limitationsserious1no serious indirectnessno serious imprecisionnone607/1301 (46.7%)550/923 (59.6%)RR 0.79 (0.69 to 0.91)125 fewer per 1000 (from 54 fewer to 185 fewer)⊕⊕⊕○
MODERATE
Non-remission
6randomised trialsno serious limitationsserious1no serious indirectnessno serious imprecisionnone496/725 (68.4%)586/716 (81.8%)RR 0.83 (0.74 to 0.94)139 fewer per 1000 (from 49 fewer to 213 fewer)⊕⊕⊕○
MODERATE
Discontinuation due to adverse events
10randomised trialsno serious limitationsno serious inconsistencyno serious indirectnessno serious imprecisionnone302/1945 (15.5%)95/1255 (7.6%)RR 2.04 (1.58 to 2.65)79 more per 1000 (from 44 more to 125 more)⊕⊕⊕⊕
HIGH
Nausea
8randomised trialsno serious limitationsno serious inconsistencyno serious indirectnessno serious imprecisionnone437/1253 (34.9%)117/976 (12%)RR 2.76 (2.28 to 3.34)211 more per 1000 (from 153 more to 281 more)⊕⊕⊕⊕
HIGH
Ejaculation disorder
3randomised trialsno serious limitationsno serious inconsistencyno serious indirectnessserious2none68/526 (12.9%)0/360 (0%)RR 36.32 (7.76 to 170.02)0 more per 1000 (from 0 more to 0 more)⊕⊕⊕○
MODERATE
Insomnia
6randomised trialsno serious limitationsserious1no serious indirectnessno serious imprecisionnone140/933 (15%)60/738 (8.1%)RR 1.56 (1.16 to 2.09)46 more per 1000 (from 13 more to 89 more)⊕⊕⊕○
MODERATE
1

I-squared >50%

2

small number of events

From: Appendix 18, GRADE evidence profiles

Cover of Generalised Anxiety Disorder in Adults
Generalised Anxiety Disorder in Adults: Management in Primary, Secondary and Community Care.
NICE Clinical Guidelines, No. 113.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2011.
Copyright © 2011, The British Psychological Society & The Royal College of Psychiatrists.

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