12-week double-blind randomized multicenter study of efficacy and safety of agomelatine (25–50 mg/day) versus escitalopram (10–20 mg/day) in out-patients with severe generalized anxiety disorder

Stein, Dan J.; Khoo, Jon Paul; Ahokas, Antti; Jarema, Marek; Ameringen, Michael Van; Vavrusova, L.; Höschl, Cyril; Bauer, Michael; Bitter, István; Sn, Mosolov; Olivier, Valérie; Matharan, Sophie; Picarel-Blanchot, F.; Bodinat, Christian de

doi:10.1016/j.euroneuro.2018.05.006

Cited by 28 publications

(21 citation statements)

References 37 publications

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“…The most commonly used SSRI in the United States, the United Kingdom, Italy, and Sweden has been shown to be citalopram, and sertraline has been reported as the most frequently used SSRI in Iran ( 2 , 23 , 24 , 27 , 43 ). Escitalopram is currently approved in over 100 countries and has been shown to have a good efficacy and safety profile ( 44 – 46 ). Escitalopram’s price varies by country.…”

Section: Discussionmentioning

confidence: 99%

Trends in Antidepressant Use and Expenditure in Six Major Cities in China From 2013 to 2018

Zhang

Zheng³

et al. 2020

Front. Psychiatry

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The objective of this study was to investigate the current status and trends in antidepressant use and expenditure in China from 2013 to 2018. The study had a retrospective design based on prescribing data on antidepressant drugs, which was sourced from the Hospital Prescription Analysis Cooperative Project. The trends in hospital visits and corresponding expenditure on antidepressant drugs were examined. Subgroup analyses were carried out by sex, age, and drug class. A total of 1,795,230 outpatient prescriptions were collected from 79 hospitals in six major cities in China. Hospital visits with antidepressant prescriptions rose significantly from 244,626 in 2013 to 348,718 in 2018, reflecting a 42.6% increase (P < 0.05). The antidepressant expenditure also rose, increasing from 48.0 million Chinese yuan in 2013 to 64.8 million Chinese yuan in 2018. There were approximately 1.6 times more antidepressant prescriptions written for women than for men. The most frequent age category for antidepressant prescriptions was 45-64 years. The most commonly prescribed antidepressants were selective serotonin reuptake inhibitors (N06AB) and other antidepressants (N06AX), whereas tricyclic antidepressants (N06AA) accounted for only a small part of the total antidepressant prescriptions. Flupentixol/melitracen and escitalopram were the most frequently prescribed antidepressants. Antidepressant prescribing rates continue to increase in China, although the prescribing patterns have changed over the past few years. The wide use of expensive antidepressants and those with weak clinical evidence raises concerns regarding the rational use of antidepressants. This study provides a basis for future stewardship by the government and medical institutions.

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Section: Discussionmentioning

confidence: 99%

Trends in Antidepressant Use and Expenditure in Six Major Cities in China From 2013 to 2018

Zhang

Zheng³

et al. 2020

Front. Psychiatry

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“…Agomelatine, a melatonin-1/melatonin-2 agonist and 5-HT 2C receptor antagonist, has been studied more extensively in depression, although it was also found to have anxiolytic properties (112). Based on several RCTs including comparisons with escitalopram (113)(114)(115)(116)(117), a meta-analysis of treatments for GAD determined that agomelatine was well-tolerated and potentially efficacious with the caveat of small sample sizes (91). Despite its apparent positive response in GAD, there are no known controlled studies of agomelatine in PD or SAD or any known ongoing trials in anxiety disorders.…”

Section: Serotonergic Agentsmentioning

confidence: 99%

Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options

et al. 2020

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Anxiety disorders are the most prevalent psychiatric disorders and a leading cause of disability. While there continues to be expansive research in posttraumatic stress disorder (PTSD), depression and schizophrenia, there is a relative dearth of novel medications under investigation for anxiety disorders. This review's first aim is to summarize current pharmacological treatments (both approved and off-label) for panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and specific phobias (SP), including selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), azapirones (e.g., buspirone), mixed antidepressants (e.g., mirtazapine), antipsychotics, antihistamines (e.g., hydroxyzine), alpha- and beta-adrenergic medications (e.g., propranolol, clonidine), and GABAergic medications (benzodiazepines, pregabalin, and gabapentin). Posttraumatic stress disorder and obsessive-compulsive disorder are excluded from this review. Second, we will review novel pharmacotherapeutic agents under investigation for the treatment of anxiety disorders in adults. The pathways and neurotransmitters reviewed include serotonergic agents, glutamate modulators, GABAergic medications, neuropeptides, neurosteroids, alpha- and beta-adrenergic agents, cannabinoids, and natural remedies. The outcome of the review reveals a lack of randomized double-blind placebo- controlled trials for anxiety disorders and few studies comparing novel treatments to existing anxiolytic agents. Although there are some recent randomized controlled trials for novel agents including neuropeptides, glutamatergic agents (such as ketamine and d-cycloserine), and cannabinoids (including cannabidiol) primarily in GAD or SAD, these trials have largely been negative, with only some promise for kava and PH94B (an inhaled neurosteroid). Overall, the progression of current and future psychopharmacology research in anxiety disorders suggests that there needs to be further expansion in research of these novel pathways and larger-scale studies of promising agents with positive results from smaller trials.

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“…Because the primary study aim was to assess whether DBS effects remain at long-term follow-up, we predefined clinically significant changes on symptom scales. We predefined Y-BOCS score increases $3 points/year, HAM-A score increases $2 points/year, and HAM-D score increases $2 points/year as clinically significant changes (19)(20)(21)(22).…”

Section: Outcome Measuresmentioning

confidence: 99%

Long-term Outcome of Deep Brain Stimulation of the Ventral Part of the Anterior Limb of the Internal Capsule in a Cohort of 50 Patients With Treatment-Refractory Obsessive-Compulsive Disorder

Graat

Mocking

Figee

et al. 2021

Biological Psychiatry

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BACKGROUND: Deep brain stimulation (DBS) is an effective intervention for patients with severe treatment-refractory obsessive-compulsive disorder (OCD). Our aim was to examine long-term effectiveness and tolerability of DBS and its impact on functioning and well-being. METHODS: Fifty patients with severe treatment-refractory OCD received DBS of the ventral part of the anterior limb of the internal capsule and were followed for at least 3 years following implantation (mean 6.8 6 3 years). Primary effectiveness was assessed by change in Yale-Brown Obsessive Compulsive Scale scores. Secondary effectiveness measures included Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, World Health Organization Quality of Life Scale-Brief Version, Global Assessment of Functioning, and a scale assessing functioning in work, family, and social life. Adverse effects of DBS were examined with a structured interview (n = 38). RESULTS: At long-term follow-up, OCD symptoms decreased by 39% (p , .001), and half of the patients were responders ($35% decrease of Yale-Brown Obsessive Compulsive Scale score). Anxiety and depressive symptoms decreased significantly, with reductions of 48% and 50%, respectively. The World Health Organization Quality of Life Scale-Brief Version general score improved significantly, as did 3 of 4 subdomains. Both clinicianand patient-rated functioning improved substantially (p , .001). The unemployment rate decreased from 78% at baseline to 58% at last follow-up (z = 21.90, p = .058), and 21 patients stopped or decreased psychotropic medication (z = 22.887, p = .004). Long-term adverse effects included cognitive complaints and fatigue. Serious adverse events included 1 suicide attempt, related to comorbid depression. CONCLUSIONS: Our results provide evidence that DBS of the ventral part of the anterior limb of the internal capsule is effective and tolerable for treatment-refractory OCD in the long term and improves functioning and overall wellbeing.

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12-week double-blind randomized multicenter study of efficacy and safety of agomelatine (25–50 mg/day) versus escitalopram (10–20 mg/day) in out-patients with severe generalized anxiety disorder

Cited by 28 publications

References 37 publications

Trends in Antidepressant Use and Expenditure in Six Major Cities in China From 2013 to 2018

Trends in Antidepressant Use and Expenditure in Six Major Cities in China From 2013 to 2018

Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options

Long-term Outcome of Deep Brain Stimulation of the Ventral Part of the Anterior Limb of the Internal Capsule in a Cohort of 50 Patients With Treatment-Refractory Obsessive-Compulsive Disorder

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12-week double-blind randomized multicenter study of efficacy and safety of agomelatine (25–50 mg/day) versus escitalopram (10–20 mg/day) in out-patients with severe generalized anxiety disorder

Cited by 28 publications

References 37 publications

Trends in Antidepressant Use and Expenditure in Six Major Cities in China From 2013 to 2018

Trends in Antidepressant Use and Expenditure in Six Major Cities in China From 2013 to 2018

Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options

Long-term Outcome of Deep Brain Stimulation of the Ventral Part of the Anterior Limb of the Internal Capsule in a Cohort of 50 Patients With Treatment-Refractory Obsessive-Compulsive Disorder

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12-week double-blind randomized multicenter study of efficacy and safety of agomelatine (25–50 mg/day) versus escitalopram (10–20 mg/day) in out-patients with severe generalized anxiety disorder