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| |  CINP: Escitalopram Shows Promise for Treatment of Panic Disorder By Heather Pengelley Special to DG News MONTREAL, QC -- June 28, 2002 -- Escitalopram, the therapeutically active component of citalopram, significantly improves symptoms and quality of life in men and women who suffer from panic disorder. This finding was presented here June 27th at the 23rd Congress of the Collegium Internationale Neuro-Psychopharmacologicum (CINP). Dr. Stephen Stahl of the University of California, San Diego, United States led a 10-week, double-blind trial in which he and his colleagues randomly assigned 247 patients with Diagnostic and Statistical Manual (DSM)-IV-defined panic disorder (with or without agoraphobia) to one of two groups. They treated one group with a 5-mg starting dose of escitalopram and the other group with a placebo. Patients ranged in age from 18 to 80. All had endured at least four panic attacks during the month before screening and at least three panic attacks during a two-week placebo run-in. Their average baseline score on the Hamilton Depression Rating Scale (HAM-D) was 17 or greater. Patients in both groups had similar baseline characteristics, including psychiatric evaluations. On average, patients in each group suffered about five panic attacks per week. The investigators measured efficacy with a battery of psychiatric evaluations, including the Modified Sheehan Panic and Anticipatory Anxiety Scale (PAAS), Panic and Agoraphobia Scale (P&A), Hamilton Anxiety Scale (HAM-A), Clinical Global Impressions of Improvement (CGI-I) and Severity (CGI-S) scales, Patient Global Evaluation (PGE), and Quality of Life Questionnaire. Core symptoms, the severity of panic attacks, and quality of life measures improved significantly in escitalopram-treated patients compared to those on placebo. Moreover, patients taking escitalopram experienced significantly fewer panic attacks than those taking a placebo (-1.61 versus -1.36 from baseline values, respectively; p=0.05). Half of escitalopram-treated patients were completely free of panic attacks compared to only 39 percent of those on placebo (p=0.05). Escitalopram-treated patients also had significant reductions the duration of anticipatory anxiety (p<0.01), all CGI scores (p<0.01), and HAM-A scores (p=0.05) compared to placebo. Escitalopram improved symptoms within four weeks. Mean changes in P&A scores for escitalopram versus placebo were significant at four weeks (p<0.05) and continued to improve over the course of study (p<0.01 at 10 weeks). Quality of life questions focused on overall life satisfaction, social and family relationships, daily functioning, and sense of well-being. By the end of study, escitalopram-treated patients’ responses had significantly improved compared to those on placebo (p<0.01). Headache, insomnia, nausea, and fatigue were the most commonly reported side effects, incidences were similar in both treatment groups. Fewer patients discontinued treatment due to adverse effects in the escitalopram group compared to placebo (6 versus 8 percent, respectively). The investigators conclude that escitalopram is not only effective but also safe and well-tolerated.
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