Efficacy of Sertraline in a 12-Week Trial for Generalized Anxiety Disorder

Allgulander, Christer; Dahl, Alv A.; Austin, Carol D.; Morris, Philip; Søgaard, J.; Fayyad, Rana; Kutcher, Stan; Clary, Cathryn M.

doi:10.1176/appi.ajp.161.9.1642

Cited by 129 publications

(74 citation statements)

References 32 publications

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“…For example, patients (n 5 930) from three separate clinical drug trials [Pollack et al, 2001;Rickels et al, 2003;Rosenthal, 2003] had a combined mean baseline SDS total score of 14.1; this score suggests moderate impairments in overall role functioning and is similar to scores reported for patients with untreated PD and MDD [Rickels et al, 2003;Sheehan et al, 1996]. One clinical drug trial [Allgulander et al, 2004] examined occupational impairment in employed subjects (n 5 208/566); subjects showed substantial impairments in occupational role functioning (M 5 29.75 on the Endicott Work Productivity scale, parts 1 and 2 [Endicott and Nee, 1997]). In addition, substantial QOL impairments were observed in the total sample (n 5 566; M 5 63% on the Quality of Life Enjoyment and Satisfaction Questionnaire [Endicott et al, 1993]).…”

Section: Mental Health Studies Examining Role And/or Qol Impairments mentioning

confidence: 89%

Human and economic burden of generalized anxiety disorder

Hoffman¹,

2008

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The goal of the current work is to provide a comprehensive review and interpretation of the literature on the human and economic burden of generalized anxiety disorder (GAD) and how it compares with that of other mental disorders. The term “human burden” is used to describe quantified impairments in role functioning and quality of life (QOL). “Economic burden” describes costs related to health care resource utilization and lost work. A review of 34 studies reporting original quantitative data on associations between GAD and role functioning, QOL, and/or economic costs was undertaken. GAD was defined by DMS‐III‐R, DSM‐IV, or ICD‐10 DCR. Persons with GAD (both with and without a comorbid mental disorder) described significant impairments due to both physical and emotional problems. Studies typically showed that role and QOL impairments of GAD were at least comparable in magnitude to those of other anxiety disorders, somatoform disorders, and physical conditions, and greater than those of substance use disorders. Large representative studies showed that role impairments of pure GAD were similar in magnitude to those of pure MDD. Studies of DSM‐IV disorders showed that QOL impairments of GAD were at least comparable in magnitude to those of MDD; studies of DSM‐III‐R disorders showed the opposite pattern. GAD was associated with considerable economic costs owing to lost work productivity and high medical resource use. Quality of care initiatives that have been implemented to increase recognition and improve treatment outcomes for persons with MDD should be extended to the effective management of GAD. Depression Anxiety 0:1–19, 2006. © 2006 Wiley‐Liss, Inc.

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Section: Mental Health Studies Examining Role And/or Qol Impairments mentioning

confidence: 89%

Human and economic burden of generalized anxiety disorder

Hoffman¹,

2008

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“…11,12 These can be summarized as follows: 1) Efficacy: In clinical trials, response rates to antidepressant medications for major depression and specific anxiety disorders are usually only about 60%. [13][14][15][16] Despite statistical separation from placebo, this therapy does not work for a substantial proportion of the clinical population. 17 2) Adequacy of response: Even among responders to antidepressant medications, a significant amount of residual symptomatology and functional impairment frequently persists, 18 often resulting in the coprescription of more medications, making polypharmacy the rule rather than the exception.…”

Section: Psychopharmacological Treatment Of Anxiety and Its Shortcommentioning

confidence: 99%

Advances in the treatment of anxiety: Targeting glutamate

Simon

Gorman

2006

NeuroRX

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Our current psychopharmacological treatments for anxiety disorders evince a number of shortcomings, including troublesome side effects and lack of primary effects. Whereas many new drugs have been developed in the past few decades, most are based on outmoded theories of the pathogenesis of these disorders (i.e., monoamine hypotheses), thus frustrating our ability to create more specific and effective interventions. Recently, however, the neurobiological literature has shown a convergence of findings focusing on the glutamatergic system in anxiety disorders, and the growth of pharmacological tools targeting these receptors has led to the development of novel treatments having anxiolytic effects in humans and animals alike. Additionally, as this system is showing promise as a final common pathway in the pathogenesis of anxiety disorders, we may be able to employ glutamate-specific neuroimaging techniques (e.g., N-acetyl-aspartate, GLX) to both guide treatment decisions and present reliable objective biomarkers for treatment efficacy.

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“…1 The current first-line anti-anxiety medication, selective serotonin/noradrenaline reuptake inhibitors (SSRIs/SNRIs), produce a delayed onset of action [2][3][4] with modest therapeutic effects and significant adverse effects. 2,3 Benzodiazepines produce rapid anti-anxiety effects, but their long-term use causes severe adverse effects.…”

Section: Introductionmentioning

confidence: 99%