Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Table 20 Strength of evidence of pharmacotherapy for SAD

Agent	Level of evidence	Agent	Level of evidence
Antidepressants
SSRIs [58, 426–429]	1	TCAs
Escitalopram [430–432]	1	Clomipramine [458, 459]	3
Fluvoxamine [433–435]	1	Imipramine [460]	3 (-ve)
Fluvoxamine CR [436, 437]	1	MAOIs and RIMAs
Paroxetine [431, 438–444]	1	Phenelzine [384, 386, 418, 461, 462]	1
Sertraline [445–448]	1	Moclobemide [417, 462–466]	1*
Fluoxetine [382, 387, 449]	1*	Other antidepressants
Citalopram [450, 451]	2	Mirtazapine [467, 468]	1*
Paroxetine CR [452]	2	Bupropion SR [469]	3
Adjunctive paroxetine [453]	3
SNRIs
Venlafaxine XR [439, 441, 454, 255, 456]	1
Duloxetine [457]	2
*Other therapies*
Anxiolytics		Anticonvulsants
Benzodiazepines		Pregabalin [474, 475]	1
Clonazepam [385, 470, 471]	1	Gabapentin [476, 477]	2
Alprazolam [386]	2	Levetiracetam [478–480]	2 (-ve)
Bromazepam [472]	2	Divalproex [481]	3
Adjunctive clonazepam [473]	2 (-ve)	Tiagabine [477, 482]	3
		Topiramate [483]	3
Other treatments		Atypical antipsychotics
Atenolol [461, 484]	1 (-ve)	Olanzapine [493]	2
Buspirone [383, 485]	1 (-ve)	Quetiapine [494, 495]	2 (-ve)
Atomoxetine [486, 487]	1*	Adjunctive aripiprazole [496]	3
Propranolol [488]	2 (-ve)	Adjunctive risperidone [271]	3
Selegiline [489]	3
Pergolide [490]	3 (-ve)
Adjunctive buspirone [491]	3
Adjunctive pindolol [492]	2 (-ve)

*Conflicting data. CR = controlled release; MAOI = monoamine oxidase inhibitor; RIMA = reversible inhibitor of monoamine oxidase A; SNRI = serotonin–norepinephrine reuptake inhibitor; SR = sustained release; SSRI = selective serotonin reuptake inhibitor; TCA = tricyclic antidepressant; XR = extended release; (-ve) = negative.

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