Treatment of generalized anxiety disorder with escitalopram: pooled results from double-blind, placebo-controlled trials.
BACKGROUND
Escitalopram 10 mg/day is an effective and well-tolerated antidepressant. Three randomized controlled trials recently evaluated the safety and efficacy of escitalopram in the treatment of generalized anxiety disorder (GAD).


METHODS
The trial designs were virtually identical, allowing data to be pooled across studies. Male and female outpatients, ages 18-80 years, with DSM-IV-defined GAD were randomized to double-blind treatment with escitalopram or placebo for 8 weeks. Escitalopram dose was fixed at 10 mg/day for the first 4 weeks, after which increases to 20 mg/day were permitted. The primary efficacy variable was the mean change from baseline in total Hamilton Anxiety Scale (HAMA) score.


RESULTS
Approximately 850 patients were randomized to double-blind treatment. In each individual study, escitalopram was significantly superior to placebo (p<0.05) as measured by change from baseline in HAMA score. By-visit analyses of data pooled across studies revealed significantly greater improvement (p<0.05) in the escitalopram group beginning at week 1 or 2 and continuing through week 8 for all primary and secondary efficacy variables. The mean change in HAMA total score from baseline to endpoint also was significantly greater for patients maintained at escitalopram 10 mg/day than for those receiving placebo. Escitalopram was generally well tolerated.


CONCLUSIONS
The studies included in this analysis were of short-term duration and excluded patients with significant medical and psychiatric comorbidities, such as major depressive disorder.


CONCLUSIONS
Results from the individual trials and the pooled analysis demonstrate that escitalopram is effective and well tolerated for the treatment of GAD.
Goodman
Wayne K
WK
Department of Psychiatry, University of Florida, PO Box 100256, Gainesville, FL 32610, USA. wkgood@psychiatry.ufl.edu
Bose
Anjana
A
Wang
Qin
Q
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000188:drug therapy*; D015283:Citalopram / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003710:Demography; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors