A Cochrane review included 5 studies. Data from four short-term RCTs (169 participants) were available for analysis. Response data from a single placebo-controlled trial of fluoxetine suggested overall superiority of medication relative to placebo ((RR 3.07, 95% CI 1.4 to 6.72, n = 67). Symptom severity was also significantly reduced in the RCTs of fluoxetine and clomipramine (relative to desipramine), as well as in the two CBT trials (WMD -44.96, 95% CI -54.43 to -35.49, n = 73). A low relapse rate (4/22) was demonstrated in one trial of CBT.
Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and by study quality (inadequate follow up).