Source: DGNews  |  Posted 8 years ago

By Cameron Johnston

TORONTO, ON -- March 31, 2003 -- Three separate phase III trials show that escitalopram is superior to placebo for controlling the symptoms of social anxiety disorder, panic disorder and generalized anxiety disorder.

Escitalopram, a single isomer selective serotonin receptor antagonist, is the therapeutically active component found in the antidepressant citalopram.

The results of the three double-blind studies, with a cohort of 433 patients ranging in age from 18-80 years, were presented here March 29th at the 23rd Annual Conference of the Anxiety Disorders Association of America.

Dr. Mark Pollack, director of the anxiety disorders program at Massachusetts General Hospital and an associate professor of psychiatry at Harvard Medical School, in Boston, Massachusetts, led the studies.

In the studies, 128 patients with panic disorder were treated with escitalopram 5 mg/day for 12 weeks; 124 patients with generalized anxiety disorder were treated with 10 mg/day for 8 weeks; and 181 patients with social anxiety disorder received 10 mg/day for 10 weeks. Each cohort was compared with a matched group of controls who received a placebo.

The doses could be titrated upward to a maximum of 20 mg/day if there was an inadequate response to the lower doses.

Primary end points were change from baseline in the number of panic attacks for those with panic disorder. For patients with generalized anxiety disorder, the primary end point was the change from baseline on the Hamilton Rating Scale for Anxiety (HAM-A), and for those with social anxiety disorder, the primary end point was the change from baseline on the Liebowitz Social Anxiety Scale (LSAS).

While the end points were somewhat different for each of the conditions, the therapeutic results were largely similar, the investigators said.

Subjects with panic disorder had experienced at least one attack per week leading up to the study, and three attacks during the two-week placebo run-in period. Their HAM-A scores were a mean of 17 or greater. At the end of the study, however, the mean change from baseline on the HAM-A was 5.3 for those in the treatment group compared with 4.8 in the placebo group, and the number of panic attacks they experienced was significantly lower than was seen in the placebo group.

Similarly, for those with social anxiety disorder, the mean change from baseline on the LSAS total score was significantly greater for those who took the study drug compared with those who received the placebo (P=.01).

In patients with generalized anxiety disorder, the mean change on the HAM-A was superior among those who received the study drug compared with those in the placebo group (P=.05).

Overall, those with social anxiety disorder had significantly better outcomes than those who received placebo on the primary end point measurements. Subjects with generalized anxiety disorder and panic disorder also did significantly better than the placebo group in terms of primary end point measurements, although the differences were not as great.

"For all three studies, escitalopram significantly improved symptoms at end points relative to baseline compared to placebo as measured by the respective primary outcome variables," the investigators concluded.

[Study title: Efficacy and Tolerability of Escitalopram in the Treatment of Anxiety Disorders. Poster 084]