How the trajectory of response to medication (and placebo response) varies among selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), benzodiazepines and across anxiety disorders is unknown.

We performed a meta-analysis using weekly symptom severity data from randomized, parallel-group, placebo-controlled trials of SSRIs, SNRIs, and benzodiazepines in adults with anxiety disorders. Response was modeled for the standardized change in anxiety using Bayesian hierarchical models.

Across 122 trials (N=15,760), SSRIs, SNRIs, and benzodiazepines produced significant improvement in anxiety compared to placebo. Benzodiazepines produced faster improvement by the first week of treatment (p < 0.001). By week 8, the response for benzodiazepines and SSRIs (p = 0.103) and SNRIs (p = 0.911) did not differ nor did SSRIs and SNRIs differ (p = 0.057), although for patients with generalized anxiety disorder (GAD), the benzodiazepines produced greater improvement than SNRIs at week 8 (difference − 12.42, CrI: −25.05 to −0.78, p = 0.037). Medication response was similar across anxiety disorders except for benzodiazepines, which produced greater improvement over the first 4 weeks compared to SSRIs and SNRIs in panic disorder. For SSRIs and SNRIs, women improved more than men, and for benzodiazepines, older patients improved more compared to younger patients. Finally, placebo response plateaued by week 4 of treatment, and, at week 8, social anxiety disorder trials had lower placebo response compared to other anxiety disorders.

Benzodiazepines show early improvement compared to SSRIs and SNRIs. However, by week 8, all treatments yield similar results. Patient characteristics influence the improvement trajectory and magnitude, suggesting potential for personalized medication selection.

选择性血清素再摄取抑制剂（SSRI）、血清素去甲肾上腺素再摄取抑制剂（SNRI）、苯二氮卓类药物和焦虑症之间的药物反应（和安慰剂反应）轨迹如何变化尚不清楚。

我们使用来自 SSRIs、SNRIs 和苯二氮卓类药物治疗成人焦虑症的随机、平行组、安慰剂对照试验的每周症状严重程度数据进行了一项荟萃分析。使用贝叶斯分层模型对焦虑的标准化变化的反应进行建模。

在 122 项试验中 (N=15,760)，与安慰剂相比，SSRIs、SNRIs 和苯二氮卓类药物显着改善了焦虑症状。苯二氮卓类药物在治疗第一周产生更快的改善（p  < 0.001）。到第 8 周，苯二氮卓类药物和 SSRIs ( p  = 0.103) 和 SNRIs ( p = 0.911)的反应 没有差异，SSRIs 和 SNRIs 也没有差异 ( p  = 0.057)，尽管对于广泛性焦虑症 (GAD) 患者来说，苯二氮卓类药物第 8 周时比 SNRI 产生了更大的改善（差异 - 12.42，CrI：-25.05 至 -0.78，p  = 0.037）。除苯二氮卓类药物外，各种焦虑症的药物反应相似，与 SSRI 和 SNRI 相比，苯二氮卓类药物在头 4 周内对恐慌症有更大的改善。对于 SSRI 和 SNRI，女性比男性改善更多，而对于苯二氮卓类药物，老年患者比年轻患者改善更多。最后，安慰剂反应在治疗第 4 周趋于稳定，并且在第 8 周，与其他焦虑症相比，社交焦虑障碍试验的安慰剂反应较低。

与 SSRI 和 SNRI 相比，苯二氮卓类药物显示出早期改善。然而，到第 8 周时，所有治疗都会产生相似的结果。患者特征影响改善轨迹和幅度，表明个性化药物选择的潜力。