Levetiracetam in generalized social anxiety disorder: a double-blind, randomized controlled trial.
OBJECTIVE
This multicenter, double-blind, placebo-controlled, 2-arm, parallel-group study was carried out to determine the effectiveness and safety of the novel anticonvulsant levetiracetam for the treatment of generalized social anxiety disorder (GSAD).


METHODS
After a 1-week, single-blind, placebo run-in period, 217 adult outpatients meeting DSM-IV criteria for social anxiety disorder, generalized type, were randomly assigned (1:1) to 12 weeks of double-blind treatment with either levetiracetam (n = 111) or placebo (n = 106). Participants were required to have scores of >or= 60 on the Liebowitz Social Anxiety Scale (LSAS) and a total score of <or= 17 on the 17-item Hamilton Depression Rating Scale (HDRS). The primary outcome measure was mean change from baseline on LSAS total score. Levetiracetam was initiated at 250 mg/d and flexibly titrated up to a maximum dose of 3,000 mg/d (1,500 mg bid). Dosage was held stable for the last 6 weeks of treatment. The study was conducted from September 2003 to June 2004.


RESULTS
No statistically significant difference was found between the adjusted mean changes in LSAS score for levetiracetam (-24.4) and placebo (-28.7) using an efficacy intent-to-treat, last- observation-carried-forward analysis. Rates of response (>or= 30% reduction in LSAS score) were similar with 41.3% (levetiracetam) and 46.6% (placebo). No significant between-group differences were found on secondary outcome measures, which included changes in Sheehan Disability Scale, Clinical Global Impression of Change, and HDRS scores.


CONCLUSIONS
Although well-tolerated, levetiracetam failed to separate from placebo in this trial for the treatment of moderate to severe GSAD.
Stein
Murray B
MB
Anxiety and Traumatic Stress Disorders Research Program, University of California San Diego, 8939 Villa La Jolla Drive, Suite 200, La Jolla, CA 92037, USA. mstein@ucsd.edu
Ravindran
Lakshmi N
LN
Simon
Naomi M
NM
Liebowitz
Michael R
MR
Khan
Arifulla
A
Brawman-Mintzer
Olga
O
Lydiard
R Bruce
RB
Pollack
Mark H
MH
D000328:Adult; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D010698:Phobic Disorders / Q000188:drug therapy; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales
D014151:Anti-Anxiety Agents; D000077287:Levetiracetam; D010889:Piracetam