title: Efficacy of escitalopram in the treatment of social anxiety disorder: A meta-analysis versus placebo.
abstract: Escitalopram is the most selective of the serotonin reuptake inhibitor (SSRI) antidepressants. We conducted a meta-analysis of placebo-controlled studies where escitalopram was used to treat patients with social anxiety disorder (SAD). Data from all randomised, double-blind placebo-controlled studies in SAD with escitalopram from both specialist settings and general practice were used. Patients met the DSM-IV criteria for SAD, were ≥18 years old, and had a Liebowitz Social Anxiety Scale (LSAS) ≥60. The primary outcome measure was the estimated treatment difference in LSAS total score at Week 12. Secondary outcome measures included the estimated treatment difference in the Clinical Global Impression-Severity (CGI-S) score at Week 12. A total of 1598 patients from 3 randomised controlled trials were included in the analyses. Escitalopram (n=1061) was superior to placebo (n=537), with an estimated treatment difference on the LSAS of -9.2 points (95%CI: [-14.4; -4.0], p<0.01) (escitalopram 5mg/day), -4.6 points (95%CI: [-8.1; -1.0], p<0.01) (escitalopram 10mg/day), -10.1 points (95%CI: [-13.7; -6.5], p<0.01) (escitalopram 20mg/day) and -7.3 points (95%CI: [-12.3; -2.2], p<0.01) (escitalopram 10-20mg/day). For the CGI-S, the corresponding values were -0.55 points (95%CI: [-0.79; -0.31], p<0.01) (escitalopram 5mg/day), -0.26 points (95%CI: [-0.42; -0.10], p<0.01) (escitalopram 10mg/day), -0.48 points (95%CI: [-0.64; -0.31], p<0.01) (escitalopram 20mg/day) and -0.29 points (95%CI: [-0.51; -0.07], p<0.05) (escitalopram 10-20mg/day). The withdrawal rate due to adverse events was 7.2% for escitalopram, compared with 4.3% for placebo (p<0.05). In this meta-analysis, all doses of escitalopram showed significant superiority in efficacy versus placebo in the treatment of patients with SAD.
authors.affiliation: Clinical and Experimental Sciences, University of Southampton, Southampton, UK; Department of Psychiatry and Mental Health, University of Cape Town, South Africa. Electronic address: dsb1@soton.ac.uk.
authors.forename: David S
authors.initials: DS
authors.lastname: Baldwin
authors.affiliation: Health Care Center and Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Asakura
authors.affiliation: Clinical Research Centre, Ohyachi Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Mochida Pharmaceutical Co., Ltd., Tokyo, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Hayano
authors.affiliation: Mochida Pharmaceutical Co., Ltd., Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hagino
authors.affiliation: H Lundbeck A/S, Valby, Denmark.
authors.forename: Elin
authors.initials: E
authors.lastname: Reines
authors.affiliation: H Lundbeck A/S, Valby, Denmark.
authors.forename: Klaus
authors.initials: K
authors.lastname: Larsen
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D006801:Humans; D000072861:Phobia, Social / Q000188:drug therapy* / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Efficacy; Escitalopram; LSAS; Meta-analysis; Placebo; Social anxiety disorder