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Escitalopram and paroxetine in the treatment of generalised anxiety disorder

Randomised, placebo-controlled, double-blind study^*

Clinical Neuroscience Division, School of Medicine, University of Southampton, UK

Anna Karina Trap Huusom, MSc

H. Lundbeck A/S, Copenhagen, Denmark

Eli Mæhlum, MSc

H. Lundbeck A/S, Lysaker, Norway

Correspondence: David S. Baldwin, University Department of Mental Health, Royal South Hants Hospital, Graham Road, Southampton SO14 0YG, UK. Tel.: +44 (0) 2380 825 533, fax: +44 (0) 2380 234 243, email: dsb1{at}soton.ac.uk7

Declaration of interest The University of Southampton has received support from Lundbeck and GlaxoSmithKline. D.S.B. has received consultancy honoraria from Lundbeck and GlaxoSmithKline. A.K.T.H. and E.M. are employees of H. Lundbeck A/S, who sponsored this study.

^* Some of the results in this manuscript were presented as a poster at the 17th Congress of the European College of Neuropsychopharmacology, Stockholm, Sweden, 9-13 October 2004

Background It is uncertain whether higher doses of selective serotonin reuptake inhibitors have greater efficacy in generalised anxiety disorder.

Aims To assess the efficacy of different doses of escitalopram in generalised anxiety disorder.

Method Randomised, double-blind, placebo-controlled, fixed-dose, parallel-group, 12-week study, with 681 patients: placebo (n=139); escitalopram, 5 mg/day, (n=134); 10 mg/day (n=136); 20 mg/day (n=133); paroxetine, 20 mg/day (n=139).

Results Mean change in the primary efficacy measure was greater with escitalopram 10 and 20 mg than with placebo; 10 mg was more efficacious than paroxetine. Paroxetine was superior to placebo on some secondary measures, at some time points. Compared with placebo, more patients withdrew because of adverse events with escitalopram 20 mg and paroxetine.

Conclusions Escitalopram was efficacious in generalised anxiety disorder, 20 was not significantly superior to 10 mg/day. Escitalopram 10 mg was more efficacious than paroxetine.

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