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The primary outcomes were efficacy (mean difference in change from baseline in HAM-A total score) and acceptability (study discontinuations for any cause). This study is registered with Open Science Framework (OSF) database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Analysis of 100 trials involving 28,637 participants showed that most active drugs were more effective than placebo in reducing anxiety. Notably, silexan was the only phytopharmaceutical included in the NMA. Clomipramine had the highest efficacy and vortioxetine the least. However, in terms of acceptability, clomipramine led to the most study discontinuations, while clobazam had the lowest discontinuation rate, indicating that efficacy and acceptability do not always align. Notably, silexan was both highly effective and as acceptable as a placebo. Only four treatments showed fewer adverse events than placebo (diazepam, agomelatine, clobazam, and silexan).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This network meta-analysis provides a unique comparison of the efficacy and acceptability of anxiolytics. It represents one of the most comprehensive evidence bases available to guide the first choice of treatment for anxiety disorders in adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00406-025-02082-0","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T11:55:20Z","timestamp":1754913320000},"page":"1879-1894","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparative efficacy and acceptability of anxiolytic drugs for the treatment of anxiety disorders: a systematic review and network meta-analysis"],"prefix":"10.1007","volume":"276","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9315-8138","authenticated-orcid":false,"given":"Thomas J.","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"K\u00fcnzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Heitlinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Kr\u00e4mer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"von K\u00e4nel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"H\u00e4ttenschwiler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Hilpert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Imboden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Holsboer-Trachsler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hatzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siegfried","family":"Kasper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borwin","family":"Bandelow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich","family":"Seifritz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"2082_CR1","volume-title":"Generalized anxiety disorder. 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M\u00fcller has received honoraria for lectures from: AstraZeneca, Bristol-Myers Squibb, Janssen, Servier, Eli Lilly, Zeller Medical, Mepha, Lundbeck, Otsuka, Sunovion, Schwabe Pharma, Takeda and Sandoz. He is or was a consultant to: Eli Lilly, Lundbeck, Otsuka, Takeda, Sunovion, Bristol-Myers Squibb, AstraZeneca, Schwabe Pharma and Janssen. Arnaud K\u00fcnzi declared, that the analysis was supported by Schwabe Pharma AG Grant through a grant. Ellen Heitlinger declared, that the medical writing was supported by Schwabe Pharma AG through a grant. Bernd Kr\u00e4mer has received honoraria for lectures from Schwabe. Roland von K\u00e4nel has received honoraria from Heel Germany. Josef H\u00e4ttenschwiler declared no interests. Matthias Hilpert declared no interests. Christian Imboden has received honoraria for advice and educational activities from Lundbeck, Schwabe, Janssen, Servier and OM Pharma. Edith Holsboer-Trachsler declared no interests. In the past three years, Siegfried Kasper has served as a consultant or on advisory boards for Angelini, Biogen, Boehringer, Esai, Janssen, IQVIA, Mylan, Otsuka Inc., Recordati, Rovi, and Schwabe; and he has served on speakers bureaus for Angelini, Aspen Farmaceutica S.A., Biogen, Janssen, Recordati, Schwabe, Servier, and Sothema. In the past three years, Martin Hatzinger has been on the speakers\u2019 board of Idorsia, Janssen, Lundbeck and Schwabe Pharma. In the past 36 months, Borwin Bandelow has been on the speakers\u2019 board for Aris, Lundbeck, Schwabe and Servier and on the advisory board for Cannaxan and Schwabe. Erich Seifritz has received grants from the Swiss National Science Foundation and the University of Z\u00fcrich and honoraria for advice and educational activities from Lundbeck, Schwabe, Janssen, Otsuka, Mepha Pharma, Otsuka Pharma, Recordati, OM Pharma, Takeda, Sunovion Pharma and Angelini.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}