Journal Title:  Annals of Clinical Psychiatry | Vol:  17 | Issue:  2 | Year:  2005   
Print ISSN:  1040-1237 | Online ISSN:  1547-3325   

Escitalopram for the Treatment of GAD: Efficacy Across Different Subgroups and Outcomes

Dan J. Stein MD, PhD
Henning Friis Andersen MSc
Wayne K. Goodman

pages: 71 - 75
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Background . Generalized anxiety disorder (GAD) is characterized by anxiety, and also frequently associated with depressive symptoms. Benzodiazepines have commonly been used in the treatment of GAD, but are not effective antidepressant agents. In this study, we determined whether the selective serotonin reuptake inhibitor escitalopram, was effective across different subgroups and outcomes (anxious symptoms, depressive symptoms, and quality of life).

Methods . Three randomized, placebo controlled studies of escitalopram in GAD have employed a similar design, allowing for pooling of the data. The primary efficacy measure was the Hamilton Anxiety Scale (HAMA). General linear models were used to determine the efficacy of escitalopram across different subgroups and outcomes.

Results . Escitalopram was efficacious for GAD on a range of measures of both anxiety and depression, and improved the associated impairment in quality of life. There was no significant interaction of effects on the HAMA with demographic or clinical variables. Furthermore, escitalopram was efficacious on both primary and secondary scales in the subgroup of subjects with above-median severity of depressive symptoms at baseline (HAMD-17>12).

Conclusions . Escitalopram reduces anxiety and depressive symptoms in GAD, and improves quality of life. It is equally effective in GAD patients, with an above-median level of depressive symptoms. Further research is needed to determine whether these results can be extrapolated to GAD patients with comorbid major depression.