Venlafaxine Extended Release vs Placebo and Paroxetine in Social Anxiety Disorder
ABSTRACT Evidence indicates that venlafaxine hydrochloride extended release (ER) effectively ameliorates anxiety symptoms.
To evaluate the efficacy, safety, and tolerability of flexible-dose venlafaxine ER compared with placebo in the short-term treatment of generalized social anxiety disorder and, secondarily, to compare paroxetine with venlafaxine ER and paroxetine with placebo.
Adult outpatients with DSM-IV generalized social anxiety disorder for 6 months or longer were randomly assigned to receive venlafaxine hydrochloride ER (75-225 mg/d), paroxetine (20-50 mg/d), or placebo for 12 weeks or less at 26 centers in the United States. The primary outcome measure was the total Liebowitz Social Anxiety Scale score. Secondary measures included response (Clinical Global Impression-Improvement score, 1 or 2) rates and Clinical Global Impression-Severity of Illness and Social Phobia Inventory scores.
Of 440 patients treated, 413 (93.9%) were included in the last-observation-carried-forward efficacy analysis; of the 429 patients in the safety population, 318 (74.1%) completed the study. Mean daily doses were 201.7 mg (SD, 38.1 mg) of venlafaxine hydrochloride ER and 46.0 mg (SD, 7.9 mg) of paroxetine. Venlafaxine ER treatment was significantly superior to placebo at weeks 1 through 12 on the Liebowitz Social Anxiety Scale and Social Phobia Inventory and at week 2 and weeks 6 through 12 for Clinical Global Impression-Severity of Illness and responder status, and was significantly superior to paroxetine treatment at weeks 1 and 2 for the Social Phobia Inventory (P < .05 for all). Paroxetine treatment was significantly superior to placebo at weeks 3 through 12 on the Liebowitz Social Anxiety Scale, the Clinical Global Impression-Severity of Illness scale, and the Social Phobia Inventory, and at weeks 4 through 12 for response (P < .05 for all). Week 12 response rates were significantly greater for the venlafaxine ER and paroxetine groups (58.6% and 62.5%, respectively) vs the placebo group (36.1%) (P < .001 for both).
Venlafaxine ER is effective in the short-term treatment of generalized social anxiety disorder, with efficacy and tolerability comparable to paroxetine.
- SourceAvailable from: Nesrin Dilbaz
- "Venlafaxine; has shown promising results in open-label and controlled trials in the treatment of SAD. Venlafaxine is an effective treatment option for generalised social anxiety disorder but has no superiority from paroxetine in clinical trials (Allgulander et al., 2004; Liebowitz et al., 2005). While venlafaxine is an effective treatment, this may be related to its serotonergic profile, and the authors are unimpressed with response to the specific noradrenergic agent reboxetine from both the literature and clinical experience. "
Chapter: Social Anxiety DisorderDifferent Views of Anxiety Disorders, 09/2011; , ISBN: 978-953-307-560-0
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ABSTRACT: This article provides a clinically relevant overview of issues related to social anxiety disorder (SAD), with particular emphasis on its diagnosis and treatment. The his-tory and evolution of SAD as a clinical syndrome are briefly reviewed, and the phenomenology and clinical presentation of SAD are discussed. Data on prevalence, onset, course, comorbidity, and function-al impairment associated with SAD in clinical and epidemiological samples are reviewed. An overview of assessment and treatment via pharmacotherapy and cogni-tive-behavioral therapy, with a focus on practical clinical applications, is also pre-sented. Finally, research aimed at integrat-ing pharmacologic and psychotherapeutic interventions to maximize long-term treat-ment effectiveness is considered.