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Evidence summaries

Hydroxyzine for Generalized Anxiety Disorder

Hydroxyzine might possibly be more effective than placebo for symptom reduction in generalized anxiety disorder, although the evidence is insufficient. Level of evidence: "D"

A Cochrane review [Abstract] 1 includes 5 RCTs with a total of 884 people with generalized anxiety disorder (GAD). As regards the number of patients showing a response, hydroxyzine was more effective than placebo (OR 0.30, 95% CI 0.15 to 0.58; 4 trials, n=417) and it was also tolerable (OR 1.49, 95% CI 0.92 to 2.40; 4 trials, n=584). Hydroxyzine was as efficacious as other anxiolytic agents, chloridiazepoxide (OR 0.75, 95% CI 0.35 to 1.62; 1 trial, n=106) and buspirone (OR 0.76, 95% CI 0.40 to 1.42; 1 trial, n=163). There was no difference between hydroxyzine and benzodiazepines in side effects (OR 1.07, 95% CI 0.60 to 1.93; 2 trials, n=327).

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), indirectness of evidence (differences in studied outcomes) and imprecise results (limited study size for each comparison).

    References

    • Guaiana G, Barbui C, Cipriani A. Hydroxyzine for generalised anxiety disorder. Cochrane Database Syst Rev 2010 Dec 8;12:CD006815. [PubMed]

Primary/Secondary Keywords