Escitalopram for persistent symptoms of generalized anxiety disorder after CBT: a pilot study.
Cognitive behavioral therapy (CBT) and pharmacotherapy are each efficacious for generalized anxiety disorder (GAD). It is not known, however, whether GAD partial and nonresponders to one treatment modality benefit from the other. This study explored acceptability and efficacy of escitalopram for persons with persistent GAD symptoms after a course of CBT. Twenty-four patients with GAD were treated with CBT and 15 completed at least 12 sessions. Eight completers continued to have clinically significant symptoms and were offered 12 weeks of treatment with escitalopram, and 7 started escitalopram treatment. During CBT, patients evidenced significant improvement in GAD, depression, and quality of life. During escitalopram treatment, patients evidenced trends toward further improvement in GAD, depression, and quality of life. Escitalopram phase completers had initially reported low-to-moderate preferences for medication treatment. Escitalopram may benefit GAD patients with clinically significant symptoms after CBT and merits further study under controlled conditions in a larger sample.
Anxiety Disorders Clinic, New York State Psychiatric Institute, New York, NY 10032, USA. frs1@columbia.edu
Franklin R
FR
Schneier
Kenneth D
KD
Belzer
Ronit
R
Kishon
Lawrence
L
Amsel
Helen Blair
HB
Simpson
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy*; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors