1.9Diazepam vs Placebo for GAD

Quality assessmentSummary of findingImportance
No of patientsEffectQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsDiazepamPlaceboRelative (95% CI)Absolute
HAM-A (Better indicated by lower values)
1randomised trialsno serious limitationsno serious inconsistencyno serious indirectnessserious1none1212-SMD 0.21 lower (1.01 lower to 0.59 higher)⊕⊕⊕○
MODERATE
Non-response
3randomised trialsno serious limitationsno serious inconsistencyno serious indirectnessno serious imprecisionnone96/247 (38.9%)149/258 (57.8%)RR 0.67 (0.54 to 0.84)191 fewer per 1000 (from 92 fewer to 266 fewer)⊕⊕⊕⊕
HIGH
Discontinuation due to adverse events
4randomised trialsno serious limitationsno serious inconsistencyno serious indirectnessserious1none20/259 (7.7%)12/270 (4.4%)RR 1.67 (0.82 to 3.39)30 more per 1000 (from 8 fewer to 106 more)⊕⊕⊕○
MODERATE
Libido
1randomised trialsno serious limitationsno serious inconsistencyno serious indirectnessserious1none5/104 (4.8%)0/104 (0%)RR 11 (0.62 to 196.43)0 more per 1000 (from 0 fewer to 0 more)⊕⊕⊕○
MODERATE
Fatigue
1randomised trialsno serious limitationsno serious inconsistencyno serious indirectnessserious2none17/104 (16.3%)6/104 (5.8%)RR 2.83 (1.16 to 6.9)106 more per 1000 (from 9 more to 340 more)⊕⊕⊕○
MODERATE
Dizziness
2randomised trialsno serious limitationsno serious inconsistencyno serious indirectnessno serious imprecisionnone16/158 (10.1%)5/161 (3.1%)RR 3.26 (1.22 to 8.7)70 more per 1000 (from 7 more to 239 more)⊕⊕⊕⊕
HIGH
1

Confidence intervals compatible with benefit and no benefit

2

data only on 1 study

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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