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Escitalopram Effective in Comorbid Social Anxiety Disorder and Major Depression: Presented at ADAA

By Bonnie Darves

SEATTLE, WA -- March 23, 2005 -- Patients who suffer from both social anxiety disorder (SAD) and major depressive disorder (MDD) may experience modest to substantial improvements in one or both conditions when treated with the selective serotonin reuptake inhibitors (SSRI) escitalopram.

Results of a new study presented here on March 20^th at the Anxiety Disorders Association of America 25^th Annual Conference showed marked improvement in depression and modest benefits in reducing SAD.

Escitalopram has been used to treat both disorders but has been little studied in patients with comorbid SAD and MDD, said study author Franklin Schneier, MD, associate professor of clinical psychiatry, College of Physicians and Surgeons of Columbia University, and assistant professor of psychiatry, New York State Psychiatric Institute, New York, New York, United States.

The results are noteworthy in that the two conditions frequently co-occur and few medications studied have demonstrated effectiveness in both conditions simultaneously, yet the researchers, affiliated with the New York State Psychiatric Institute in New York, stressed the need for further, larger studies incorporating a placebo-controlled design.

Dr. Schneier, MD, and colleagues conducted a 12-week, open-label study to characterize patients with generalized SAD and comorbid MDD, and to assess response to escitalopram treatment. They enrolled 20 patients, whose mean age was 32 years. Patients had Leibowitz Social Anxiety Scale score of 50 or higher and Hamilton depression rating score of 15 or higher.

Treatment was 10 mg to 20 mg daily of escitalopram for up to 12 weeks (mean dose 15 mg). Fifteen (75%) of patients completed 6 weeks of treatment and 11 remained on medication for 12 weeks.

Response rates for the intention-to-treat sample was 30% for patients with SAD and 70% for those with major depression, 30% responded for both conditions.

Disability and quality of life also showed significant improvement, and 60% of patients reported they were "very much improved" with regard to their MDD. Among all patients Clinical Global Impression (CGI) - Social Anxiety scores declined a mean of 1.1 points, from 5.0 to 3.9, and CGI-Depression scores declined to a mean of 2.6, from 4.5 at baseline.

The researchers noted that those who saw improvement in SAD tended to experience that benefit later in the treatment cycle, which suggests that longer-term treatment may be needed to achieve a better response.

The study was supported by Forest Laboratories.


[Presentation title: Escitalopram Treatment of Social Anxiety Disorder with Comorbid Major Depression. Poster 108]

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