my personal edition > anxiety > news


  E-Mail this DGDispatch to a colleague

DGDispatch

Significant Quality-Of-Life Improvements Seen In Patients With Generalized Anxiety Disorder Treated With Escitalopram: Presented at ADAA

By Cameron Johnston

TORONTO, ON -- April 1, 2003 -- Patients with generalized anxiety disorder (GAD) who are treated with escitalopram fare significantly better than do those treated with placebo, say researchers.

These improvements are seen on a number of measurements for depression and anxiety – and show particularly strong improvements in quality-of-life measurements, it was reported here at the 23^rd Annual Conference of the Anxiety Disorders Association of America.

In presenting the results of a double-blind, placebo-controlled 8-week study, the investigators showed that using escitalopram is beneficial in reducing the symptoms of GAD, and that the drug should be considered a first-line therapy for treating this condition.

The principal investigator was Jonathan R.T. Davidson, MD, professor of psychiatry and director of the anxiety and traumatic stress program from Duke University Medical Center, in Durham, North Carolina, United States.

The study involved 158 subjects who received escitalopram and 157 who received a placebo. After a 1-week run-in period, the subjects were followed for a further 8 weeks. The patients were, on average, 39 years of age, and slightly more than half were female. Approximately 70% were Caucasian.

There was a mean 11.3 point reduction in the total Hamilton Rating Scale for Anxiety at the end of the study among those using the study drug, compared with a reduction of 7.4 points for those receiving the placebo.

On the Hamilton subscales for psychic anxiety and somatic anxiety, the reductions in scores were 6.4 versus 3.8 and 4.8 versus 3.6 for those receiving escitalopram and placebo, respectively.

Other responses that were clinically relevant were the reductions in hospital anxiety and depression subscales for anxiety and depression. On the depression subscale, the change from baseline was 2.7 versus 0.8, and on the anxiety subscale, there was a decline of 4.4 versus 1.7 points for those receiving escitalopram and placebo, respectively.

In all, the changes seen on 11 out of 12 measurements were statistically significant (P=0.001) in favour of escitalopram over placebo, the investigators reported. In particular, there was a 5-fold difference between scores on a standard quality-of-life index: 1.7 for the placebo patients compared with 8.4 for those in the active treatment group.

The data seemed to indicate that the treatment effect was not short-lived, with 36% of escitalopram users in remission at week 8 compared with only 16% of placebo-treated subjects.

Although the percentage of subjects complaining of headache and nausea was more than doubled between the active treatment group and the placebo group, the rate of discontinuation between groups was not statistically significant (8.9% versus 5.1%, escitalopram and placebo, respectively).

The investigators concluded that these data indicate that escitalopram 10 mg/day is safe and effective for treating GAD, with relatively few serious side effects, and that treatment with this drug can make a significant improvement in the patient's quality of life as well as in a number of other emotional and psychological domains.

[Study title: Escitalopram in the Treatment of Generalized Anxiety Disorder: A Double-Blind, Placebo Controlled, Flexible Dose Study. Abstract P95.]

E-Mail this DGDispatch to a colleague

To print, use this version