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Aripiprazole as Augmentation Treatment of Refractory Generalized Anxiety Disorder and Panic Disorder

  • Elizabeth A. Hoge, John J. Worthington, Rebecca E. Kaufman, Hannah R. Delong, Mark H. Pollack and Naomi M. Simon...
Abstract
Introduction:

Individuals with anxiety disorders often remain symptomatic despite treatment with a first-line pharmacologic agent. More research examining pharmacotherapy augmentation strategies to improve outcomes is needed.

Methods:

In an 8-week, open-label, prospective augmentation study, we examined the efficacy and tolerability of the novel antipsychotic agent aripiprazole for adult outpatients with generalized anxiety disorder (n=13) or panic disorder (n=10) who remained symptomatic despite treatment for at least 8 weeks with an adequate (or maximally tolerated) dose of typical pharmacotherapy.

Results:

Aripiprazole augmentation was associated with a significant reduction in Clinical Global Impressions-Severity scores (paired t=4.41, df=22, P<.001) in the intent-to-treat sample of 23 individuals. Three subjects (13%) discontinued due to sedation, chest discomfort, and restlessness, respectively.

Conclusion:

These data provide preliminary evidence that aripiprazole may be a useful augmentation strategy for individuals with generalized anxiety disorder or panic disorder who show a limited response to initial pharmacotherapy.

Copyright
Corresponding author
Please direct all correspondence to: Elizabeth A. Hoge, MD, Massachusetts General Hospital, Simches Research Building, 185 Cambridge St., Suite 2200, 2nd Floor, Boston, MA 02114; Tel: 617-724-0859, Fax: 617-643-3080; E-mail: ehoge@partners.org.
References
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Faculty Disclosures: Dr. Hoge receives research/grant support from AstraZeneca, Bristol-Myers Squibb, Cephalon, Eli Lilly, Forest, GlaxoSmithKline, Janssen, the National Institutes of Health, Pfizer, Sepracor, and UCB Pharma. Dr. Worthington receives research/grant support from Abbott, Alkermes, Aspect Medical Systems, AstraZeneca, Bristol-Myers Squibb, Cephalon, Eli Lilly, Forest, GlaxoSmithKline, Johnson and Johnson, Lichtwer Pharma, Lorex, Novartis, Organon, PamLab, Pfizer, Pharmative, Roche, sanofi-aventis, Sepracor, Solvay, UCB Pharma, and Wyeth; and is on the speaker's bureaus of Bristol-Myers Squibb, Eli Lilly, Forest, GlaxoSmithKline, Pfizer, sanofi-aventis, and Wyeth. Mses. Kaufman and Delong do not have an affiliation with or financial interest in any organization that might pose a conflict of interest. Dr. Pollack is an advisor/consultant for AstraZeneca, Brain Cells, Bristol-Myers Squibb, Cephalon, Dov, Eli Lilly, Forest, GlaxoSmithKline, Janssen, Jazz, Medavante, Neurocrine, Neurogen, Novartis, Otsuka, Pfizer, Predix, Roche, sanofi-aventis, Sepracor, Solvay, Tikvah Therapeutics, Transcept, UCB Pharma, and Wyeth; receives research/grant support from AstraZeneca, Bristol-Myers Squibb, Cephalon, Cyberonics, Eli Lilly, Forest, GlaxoSmithKline, Janssen, NARSAD, the National Institute on Drug Abuse, the National Institute of Mental Health, Pfizer, Roche, Sepracor, UCB Pharma, and Wyeth; is on the speaker's bureaus of Bristol-Myers Squibb, Eli Lilly, Forest, GlaxoSmithKline, Janssen, Pfizer, Solvay, and Wyeth; and holds equity in Medavante and Mensante. Dr. Simon receives research/grant support from AstraZeneca, Bristol-Myers Squibb, Cephalon, Eli Lilly, Forest, GlaxoSmithKline, Janssen, NARSAD, the National Institute of Mental Health, Pfizer, Sepracor, and UCB Pharma; is on the speaker's bureaus of Eli Lilly, Forest, Janssen, Pfizer, Sepracor, and UCB Pharma; is an advisor for Solvay; and is a consultant to Paramount Biosciences.

Funding/Support: This study was supported by an investigator-initiated Collaborative Research Trial grant from Bristol-Myers Squibb.

Off-label Usage Disclosures: The authors disclose that they will discuss off-label or investigational uses of aripiprazole, olanzapine, quetiapine, and risperidone for the treatment of general anxiety disorder.

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CNS Spectrums
  • ISSN: 1092-8529
  • EISSN: 2165-6509
  • URL: /core/journals/cns-spectrums
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