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: Stefan G Hofmann[Show abstract] [Hide abstract]
ABSTRACT: Introduction: Social anxiety disorder (SAD) is a common mental health problem that tends to be chronic in nature; fortunately, effective pharmacotherapy options exist. The current study provides an updated meta-analytic review of their efficacy and potential guidelines for their application in SAD. Methods: A comprehensive search of the current literature yielded 39 randomized, pill placebo-controlled trials of pharmacotherapy for adults diagnosed with SAD. Data on potential moderators of treatment outcome were collected, as well as data necessary to calculate effect sizes using Hedges's g. Results: The overall effect size of pharmacotherapy for SAD is small to medium (Hedges's g = 0.39). The most effective pharmacotherapy type was phenelzine (Hedges's g = 1.14), followed by paroxetine (Hedges's g = 0.49), venlafaxine ER (Hedges's g = 0.45) and moclobemide (Hedges's g = 0.23). Conclusion: Effect sizes were not moderated by age, sex, length of treatment, diagnostic subtype initial severity, maximum potential dose, or publication year. It is concluded that pharmacotherapy is effective for treating SAD, but there is considerable variation and room for further improvement. Future directions may include pharmacological enhancement of psychological processes, such as d-cycloserine augmentation of exposure procedures.Expert Opinion on Pharmacotherapy 10/2014; 15(16):1-11. DOI:10.1517/14656566.2014.955472 · 3.09 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Accession Number: 79354328; Öyekçin, Demet Güleç 1; Email Address: email@example.com Yıldız, Deniz 2; Affiliation: 1: Yrd. Doç. Dr., 18 Mart Üniversitesi, Tıp Fakültesi, Psikiyatri AD, Çanakkale-Türkiye 2: Ar. Gör. Dr., 18 Mart Üniversitesi, Tıp Fakültesi, Psikiyatri AD, Çanakkale-Türkiye; Source Info: Mar2012, Vol. 2 Issue 1, p34; Subject Term: PERSONALITY disorders -- Treatment; Subject Term: PSYCHIATRIC drugs; Subject Term: DRUGS -- Effectiveness; Subject Term: MOOD stabilizers; Subject Term: ANTIDEPRESSANTS; Author-Supplied Keyword: borderline personality disorder; Author-Supplied Keyword: personality disorders; Author-Supplied Keyword: pharmacotherapy; Author-Supplied Keyword: borderline kişilik bozukluğu; Author-Supplied Keyword: farmakoterapi; Author-Supplied Keyword: kişilik bozuklukları; Language of Keywords: English; Language of Keywords: Turkish; NAICS/Industry Codes: 325411 Medicinal and Botanical Manufacturing; NAICS/Industry Codes: 325410 Pharmaceutical and medi03/2012; 2(1):34-46.
[Show abstract] [Hide abstract]
ABSTRACT: Pharmacotherapy of Personality Disorders Objective: Prevalence of personality disorders have been reported as 10-13% in general population, 30-50% in psychiatric patients, and 15% in psychiatric outpatients. The most common personality disorders are respectively borderline, antisocial, schizotypal, and avoidant. There has been no specific pharmacological approach for the treatment of personality disorders that have different clinical features with various co-morbid psychiatric disorders. The aim of this report is to review the efficacy of psychotropic medications used for the treatment of personality disorders. Methods: By using "borderline, antisocial, schizotypal, narcissistic, obsessive compulsive, avoidant personality, and pharmacotherapy" as keywords at the Pubmed database we primarily searched for the double blind, placebo controlled, randomized trials and also included some of the open label trials. Results: Most of the research on this topic was on pharmacotherapy of borderline personality disorder. Polypharmacy, that has been used widely in treatment of these cases, has been reported ineffective in most of the patients. The antidepressants have been replaced by mood stabilizers. The antidepressants and mood stabilizers have been reported to decrease mood symptoms like anger, depression, dysphoria, and to enhance adherence to psychotherapy. The most effective mood stabilizer was divalproex. The antipsychotics have been recommended to be used at psychotic and behavioral symptomatology. At the treatment of antisocial personality disorder CBT is recommended and there was no evidence based pharmacotherapy. In the treatment of schizotypal personality disorder, the antipsychotics have been reported effective. Pergolide and guanfacine have been reported to be useful in the treatment of cognitive disorders. The first line treatment options of avoidant personality disorder are venlafaxine and SSRIs. Conclusions: Most of the studies in literature have been focused at borderline personality disorder that has been difficult to treat. According to the guidelines, psychotherapy is the first line treatment for personality disorders. Pharmacotherapy has been reported to increase the efficiency of psychotherapy in BPD which presents with various symptoms of mood, cognition, and behavior. The studies in the literature report that Polypharmacy is not useful for these patients contrary to the popular belief. The research about other personality disorders is limited. More clear understanding of etiopathogenesis of personality disorders; would be helpful in development of more effective pharmacological agents in their treatment.03/2012; 2(1):31-46. DOI:10.5455/jmood.20120328094704