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Bupropion XL Has Strong Antianxiety Properties: Presented at ADAA

By Fran Lowry

MIAMI, F.L. -- March 29, 2006 -- Results of a pilot trial comparing bupropion XL with escitalopram in patients with generalized anxiety disorder (GAD) show a robust antianxiety effect for bupropion that far exceeds escitalopram's effect, researchers reported at the 26^th Annual Conference of the Anxiety Disorders Association of America (ADAA).

Alexander Bystritsky, MD, director, Anxiety Disorders Program, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, United States, presented the findings.

Although bupropion XL is an established medication for the treatment of major depression, there are no data on its use in GAD, he said. This is surprising considering that most drugs used to treat major depression are also used to treat GAD, he added.

Past reports showed that bupropion lacked efficacy and exacerbated anxiety during the start of treatment in patients with panic disorder. Yet most antidepressants, including tricyclics and SSRIs, often exacerbate symptoms during treatment initiation

His research team compared the efficacy of bupropion XL and escitalopram in a double-blind, dose-controlled, parallel-group study that enrolled 34 subjects with anxiety.

Subjects were randomly assigned by a computer program to bupropion XL (n=16) or escitalopram (n=18). After a baseline visit, patients were followed for 12 weeks.

For enrollment, subjects had to meet the Diagnostic and Statistical Manual IV (DSM-IV) criteria for GAD. They also had to score 12 or greater on the Hamilton Anxiety Rating Scale (HARS) and no more than 19 on the Hamilton Depression Rating Scale (HDRS). In addition to the HARS and HDRS scales, the other primary outcome measure was change in Self Efficacy Scale (SES).

The results of the study showed that both groups had a significant decrease in anxiety at follow up. Analysis of variance demonstrated that both HARS and HDRS total scores were significantly improved in bupropion XL-treated subjects compared to escitalopram-treated subjects (P <.005 and P <.025, respectively).

Subjects treated with bupropion XL also had significantly lower SES scores compared to the escitalopram group (P =.0002), Dr. Bystritsky reported.

"Subjects taking bupropion XL showed more improvement in their ability to cope with fear (resilience) than subjects taking escitalopram. Compared to the other efficacy measures, the SES scale demonstrated the greatest effect size," he commented.

Adverse effects were similar in both groups, Dr. Bystritsky said.


[Presentation title: A Pilot Controlled Trial of Bupropion XL vs. Es-Citalopram in Generalized Anxiety Disorder (GAD). Abstract 317]

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