Paroxetine Treatment of Generalized Anxiety Disorder: A Double-Blind, Placebo-Controlled Study

Rickels, Karl; Zaninelli, Rocco; McCafferty, James P.; Bellew, Kevin M.; Iyengar, Malini; Sheehan, David V.

doi:10.1176/appi.ajp.160.4.749

Cited by 174 publications

(89 citation statements)

References 28 publications

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“…Given the strong correlation of these states, caregivers must screen for depression when patients report anxiety or appear anxious. Selective serotonin reuptake inhibitors should be considered to treat anxiety, given their anxiolytic effects, [47][48][49][50] antidepressant effects, relatively safe profile, and possible cardiac protectiveness. 50,51 Tricyclic antidepressants, although quite efficacious for anxiety, are not recommended for IHD and CHF patients because of their cardiac effects.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Anxiety and Depression in Patients With Chronic Heart Failure

et al. 2004

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Background— Anxiety is often present with depression and may be one of its manifestations. Although the adverse effects of depression in patients with chronic heart failure (CHF) have been well studied, the relation between anxiety and CHF prognosis has not been addressed. In a secondary analysis of data collected for a published study of depression and prognosis in patients with CHF, we examined the relations among anxiety, depression, and prognosis. Methods and Results— We measured symptoms of anxiety with the Spielberger State-Trait Anxiety Inventory (STAI) scale and symptoms of depression with the Beck Depression Inventory (BDI) scale in 291 patients with CHF hospitalized as a result of cardiac events. We followed up these patients for all-cause mortality over 1 year. The mean scores for state anxiety (State-A) and trait anxiety (Trait-A) were identical at 33.5; the mean BDI score was 8.7±7.6. State-A and Trait-A scores correlated highly with each other ( r =0.85; P <0.01) and with BDI score (State-A, r =0.52; Trait-A, r =0.59; P <0.01). Cox proportional-hazards model with and without confounding variables showed no relation between State-A or Trait-A and 1-year mortality. BDI scores, however, significantly predicted increased mortality during 1-year follow-up (hazard ratio, 1.04 for each 1-unit increase; P <0.01). Conclusions— Although anxiety and depression are highly correlated in CHF patients, depression alone predicts a significantly worse prognosis for these patients.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Anxiety and Depression in Patients With Chronic Heart Failure

et al. 2004

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“…In a 24-week study, escitalopram and paroxetine were equally effective ) (A). Á Paroxetine was effective in DBPC studies Rickels et al 2003). Long-term efficacy for paroxetine was established in a 24-week placebo controlled study following an 8-week open treatment with paroxetine (Stocchi et al 2003) and a 24-week comparison with escitalopram )(A).…”

Section: Generalized Anxiety Disorder (Gad)mentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

718

410

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In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo-or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/ SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

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“…3 Furthermore, somatic symptoms are typically (but not always) less responsive to treatment with SSRI and SNRI anxiolytics. [26][27][28] In contrast, treatment with benzodiazepines is associated with more consistent improvement in somatic anxiety symptoms.…”

Section: Efficacymentioning

confidence: 99%

Pharmacotherapy Update: Pregabalin in the Treatment of Generalized Anxiety Disorder

Montgomery

Kasper

2010

Clinical Medicine Insights: Therapeutics

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Generalized anxiety disorder (GAD) is a common disorder that is chronic, disabling, and often goes undiagnosed. Currently, four distinct classes of medications have demonstrated efficacy in the treatment of GAD: benzodiazepines, serotonin and/or norepinephrine reuptake inhibitors (SSRIs/SNRIs), histamine H 1 receptor blockers (hydroxyzine), and pregabalin. Pregabalin acts via binding to an α2-δ subunit presynaptic membrane protein that inhibits neurotransmitter release in excited neurons. Pregabalin is renally excreted and undergoes minimal (2%) hepatic metabolism, thus limiting the risk of drug-drug interactions. The efficacy of pregabalin for the treatment of GAD has been established based on the results of 8 double-blind, placebo-controlled, short-term led trials, and one 6-month relapse prevention study. The current review summarizes data showing that pregabalin has a significantly different safety profile from the benzodiazepines (eg, less sedation, less cognitive and psychomotor impairment, less risk of dependence and withdrawal), and SSRI/ SNRI anxiolytics (eg, less gastrointestinal side effects and sexual dysfunction). The review also summarizes efficacy data showing that pregabalin is a broad spectrum anxiolytic that with a speed of onset similar to the benzodiazepines.

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Paroxetine Treatment of Generalized Anxiety Disorder: A Double-Blind, Placebo-Controlled Study

Abstract: This study demonstrates that paroxetine is an efficacious and well-tolerated treatment for generalized anxiety disorder.

Cited by 174 publications

References 28 publications

Prognostic Value of Anxiety and Depression in Patients With Chronic Heart Failure

Prognostic Value of Anxiety and Depression in Patients With Chronic Heart Failure

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Pharmacotherapy Update: Pregabalin in the Treatment of Generalized Anxiety Disorder

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