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Escitalopram and paroxetine in the treatment of generalised anxiety disorder: Randomised, placebo-controlled, double-blind study

  • David S. Baldwin (a1), Anna Karina Trap Huusom (a2) and Eli Mæhlum (a3)

Abstract

Background

It is uncertain whether higher doses of selective serotonin reuptake inhibitors have greater efficacy in generalised anxiety disorder.

Aims

To assess the efficacy of different doses of escitalopram in generalised anxiety disorder.

Method

Randomised, double-blind, placebo-controlled, fixed-dose, parallel-group, 12-week study, with 681 patients: placebo (n=139); escitalopram, 5 mg/day, (n=134); 10 mg/day (n=136); 20 mg/day (n=133); paroxetine, 20 mg/day (n=139).

Results

Mean change in the primary efficacy measure was greater with escitalopram 10 and 20 mg than with placebo; 10 mg was more efficacious than paroxetine. Paroxetine was superior to placebo on some secondary measures, at sometime points. Compared with placebo, more patients withdrew because of adverse events with escitalopram 20 mg and paroxetine.

Conclusions

Escitalopram was efficacious in generalised anxiety disorder, 20 was not significantly superior to 10 mg/day Escitalopram 10 mg was more efficacious than paroxetine.

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Copyright

Corresponding author

David S. Baldwin, University Department of Mental Health, Royal South Hants Hospital, Graham Road, Southampton SO14 0YG, UK. Tel.: +44 (0) 2380 825 533, fax: +44 (0) 2380 234 243, email: dsbl@soton.ac.uk

Footnotes

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Declaration of interest

The University of Southampton has received support from Lundbeck and GlaxoSmithKline. D.S.B. has received consultancy honoraria from Lundbeck and GlaxoSmithKline. A.K.T.H. and E.M. are employees of H. Lundbeck A/S, who sponsored this study.

Some of the results in this manuscript were presented as a poster at the 17th Congress of the European College of Neuropsychopharmacology, Stockholm, Sweden, 9–13 October 2004

Footnotes

References

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Allgulander, C., Dahl, A., Austin, C., et al (2004) Efficacy of sertraline in a 12-week trial for generalized anxiety disorder. American Journal of Psychiatry, 161, 16421649.
Allgulander, C., Florea, I. & Huusom, A. K. T. (2005) Prevention of relapse in generalised anxiety disorder by escitalopram treatment. International Journal of Neuropsychopharmacology, 2005. doi: 10.1017/81461145705005973
American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision) (DSM–IV–TR). Washigton, DC: APA.
Baldwin, D. S. & Polkinghorn, C. (2005) Evidence-based pharmacological treatment of generalised anxiety disorder. International Journal of Neuropsychopharmacology, 8, 293302.
Bielski, R. J., Bose, A. & Chang, C. C. (2005) A double-blind comparison of escitalopram and paroxetine in the long-term treatment of generalized anxiety disorder. Annals of Clinical Psychiatry, 17, 6569.
Brawman-Mintzer, O., Knapp, R. G., Rynn, M., et al (2006) Sertraline treatment for generalized anxiety disorder: a randomized, double-blind, placebo-controlled study. Journal of Clinical Psychiatry, 67, 874881.
Burke, W. J., Gergel, I. & Bose, A. (2002) Fixed-dose trial of the single isomer SSRI escitalopram in depressed outpatients. Journal of Clinical Psychiatry, 63, 331336.
Davidson, J. R. T., Bose, A., Korotzer, A., et al (2004) Escitalopram in the treatment of generalized anxiety disorder: a double-blind, placebo controlled, flexible dose study. Depression and Anxiety, 19, 234240.
Everitt, B. S. & Wessely, S. (2004) Clinical Trials in Psychiatry. Oxford: Oxford University Press.
Goodman, W. K., Bose, A. & Wang, Q. (2005) Treatment of generalized anxiety disorder with escitalopram: pooled results from double-blind, placebo-controlled trials. Journal of Affective Disorders, 87, 161167.
Guy, W. (1976) ECDEU Assessment Manual for Psychopharmacology. US Department of Health, Education, and Welfare. DHEW Publication No. (ADM) 218–222. Kensington, MD: George Washington University.
Hamilton, M. (1959) The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 5055.
ICH (1996) ICH Harmonised Tripartite Guideline E6: Guideline for Good Clinical Practice. http://www.ich.org/LOB/media/MEDIA482.pdf
Katz, I. R., Reynolds, C. F. III, Alexopoulos, G. S., et al (2002) Venlafaxine ER as a treatment for generalized anxiety disorder in older adults: pooled analysis of five randomized placebo-controlled clinical trials. Journal of the American Geriatric Society, 50, 1825.
Kessler, R. C., Keller, M. B. & Wittchen, H. U. (2001) The epidemiology of generalised anxiety disorder. Psychiatric Clinics of North America, 24, 1939.
Lader, M., Stender, K., Bürger, V., et al (2004) Efficacy and tolerability of escitalopram in 12- and 24-week treatment of social anxiety disorder: randomised, double-blind, placebo controlled, fixed-dose study. Depression and Anxiety, 19, 241248.
Lepola, U. M., Loft, H. & Reines, E. H. (2003) Escitalopram (10–20 mg/day) is effective and well tolerated in a placebo-controlled study in depression in primary care. International Clinical Psychopharmacology, 18, 211217.
Montgomery, S. & van Zwieten-Boot, B. (2002) ECNP Consensus Meeting March 2000 Guidelines for Investigating Efficacy in GAD. European Neuropsychopharmacology, 12, 8187.
Montgomery, S. A. & Åsberg, M. (1979) Anew depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389.
Pollack, M. H., Zaninelli, R., Goddard, A., et al (2001) Paroxetine in the treatment of generalised anxiety disorder: results of a placebo-controlled, flexible-dosage trial. Journal of Clinical Psychiatry, 62, 350358.
Rickels, K., Zaninelli, R., McCafferty, J., et al (2003) Paroxetine treatment of generalised anxiety disorder; a double-blind, placebo-controlled study. American Journal of Psychiatry, 160, 749756.
Rosenbaum, J. F., Fava, M., Hoog, S. L., et al (1998) Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial. Biological Psychiatry, 44, 7787.
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., et al (1998) The Mini International Neuropsychiatric Interview (M.I.N.I): the development and validation of a structured diagnostic psychiatric interview for DSM–IV and ICD–10. Journal of Clinical Psychiatry, 59, 2233.
White, I. R., Moodie, E., Thompson, S. G., et al (2003) A modelling strategy for the analysis of clinical trials with partly missing longitudinal data. International Journal of Methods in Psychiatric Research, 12, 139150.
World Medical Association (2000) Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. http://www.wma.net/e/policy/b3.htm
Zigmond, A. S. & Snaith, R. P. (1983) The Hospital Anxiety and Depression scale. Acta Psychiatrica Scandinavica, 67, 361370.

Escitalopram and paroxetine in the treatment of generalised anxiety disorder: Randomised, placebo-controlled, double-blind study

  • David S. Baldwin (a1), Anna Karina Trap Huusom (a2) and Eli Mæhlum (a3)

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Escitalopram and paroxetine in the treatment of generalised anxiety disorder: Randomised, placebo-controlled, double-blind study

  • David S. Baldwin (a1), Anna Karina Trap Huusom (a2) and Eli Mæhlum (a3)
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