Early improvement predicts 8-week treatment outcome in patients with generalized anxiety disorder treated with Escitalopram or Venlafaxine
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- 英文论文题名：Early improvement predicts 8-week treatment outcome in patients with generalized anxiety disorder treated with Escitalopram or Venlafaxine
- 论文作者：Mincai Qian ; Zhongxia Shen ; Min Lin ; Tiefeng Guan ; Jianhong Yang ; Liang Li ; Xinhua shen ; Yonggui Yuan
- 英文论文作者：Mincai Qian ; Zhongxia Shen ; Min Lin ; Tiefeng Guan ; Jianhong Yang ; Liang Li ; Xinhua shen ; Yonggui Yuan ; Department of Neurosis and Psychosomatic Diseases.Huzhou Third Municipal Hospital ; Department of Neuropsychiatry Affiliated ZhongDa Hospital ; Medical School of Southeast University
- 年：2014
- 作者机构：Department of Neurosis and Psychosomatic Diseases.Huzhou Third Municipal Hospital;Department of Neuropsychiatry Affiliated ZhongDa Hospital,Medical School of Southeast University;
- 英文论文关键词：Generalized anxiety disorder ; escitalopram ; venlafaxine ; efficacy ; early improvement
- 会议召开时间：2014-11-20
- 会议录名称：2014浙江省医学会精神病学分会学术年会、浙江省医师协会精神科医师分会第七届年会论文汇编
- 语种：英文
- 分类号：R749.72
- 学会代码：ZJKX
- 会议名称：2014浙江省医学会精神病学分会学术年会、浙江省医师协会精神科医师分会第七届年会
- 会议地点：中国浙江湖州
- 主办单位：浙江省医学会精神病学分会（The Society of Psychiatry ; ZJMA）、浙江省医师协会精神科医师分会
- 学会名称：浙江省科学技术协会
- 页数：5
- 文件大小：362k
- 原文格式：O
- 会议级别：地方
摘要
Objective To investigate whether early improvement can predict 8-week treatment outcome in patients with generalized anxiety disorder(GAD) treated with escitalopram or venlafaxine.Methods 226 GAD patients were randomly assigned to receive either escitalopram or venlafaxine for 8 weeks.The severity of the disease was evaluated with Hamilton anxiety rating scale(HAMA) and Hamilton depression rating scale(HAMD) at baseline and at the end of the 1st,2ed,4th,and 8th week,respectively.Early improvement was defined as a ≧ 20%reduction from baseline in HAMA score at week 1 or 2,remission as the HAMA score of ￡7,response as a≧ 50%reduction from baseline in HAMA score,and nonresponse as a <50%reduction from baseline in HAMA score,respectively.The sensitivity,specificity,positive predictive value,and negative predictive value were calculated.Results In escitalopram-treated patients,the positive and negative predictive value of the early improvement at week 1 were 85.19%and 67.53%,and that at week 2 were 53.75%and 79.17%;In venlafaxine-treated patients,the positive and negative predictive value of the early improvement at week 1 were 84.62%and 65.33%,and that at week 2 were 59.21%and 88.00%,respectively.Conclusion The early improvement achieved within the first week of escitalopram or venlafaxine treatment can predict a good 8-week treatment outcome in GAD patients.
Objective To investigate whether early improvement can predict 8-week treatment outcome in patients with generalized anxiety disorder(GAD) treated with escitalopram or venlafaxine.Methods 226 GAD patients were randomly assigned to receive either escitalopram or venlafaxine for 8 weeks.The severity of the disease was evaluated with Hamilton anxiety rating scale(HAMA) and Hamilton depression rating scale(HAMD) at baseline and at the end of the 1st,2ed,4th,and 8th week,respectively.Early improvement was defined as a ≧ 20%reduction from baseline in HAMA score at week 1 or 2,remission as the HAMA score of ￡7,response as a≧ 50%reduction from baseline in HAMA score,and nonresponse as a <50%reduction from baseline in HAMA score,respectively.The sensitivity,specificity,positive predictive value,and negative predictive value were calculated.Results In escitalopram-treated patients,the positive and negative predictive value of the early improvement at week 1 were 85.19%and 67.53%,and that at week 2 were 53.75%and 79.17%;In venlafaxine-treated patients,the positive and negative predictive value of the early improvement at week 1 were 84.62%and 65.33%,and that at week 2 were 59.21%and 88.00%,respectively.Conclusion The early improvement achieved within the first week of escitalopram or venlafaxine treatment can predict a good 8-week treatment outcome in GAD patients.
Objective To investigate whether early improvement can predict 8-week treatment outcome in patients with generalized anxiety disorder(GAD) treated with escitalopram or venlafaxine.Methods 226 GAD patients were randomly assigned to receive either escitalopram or venlafaxine for 8 weeks.The severity of the disease was evaluated with Hamilton anxiety rating scale(HAMA) and Hamilton depression rating scale(HAMD) at baseline and at the end of the 1st,2ed,4th,and 8th week,respectively.Early improvement was defined as a ≧ 20%reduction from baseline in HAMA score at week 1 or 2,remission as the HAMA score of ￡7,response as a≧ 50%reduction from baseline in HAMA score,and nonresponse as a <50%reduction from baseline in HAMA score,respectively.The sensitivity,specificity,positive predictive value,and negative predictive value were calculated.Results In escitalopram-treated patients,the positive and negative predictive value of the early improvement at week 1 were 85.19%and 67.53%,and that at week 2 were 53.75%and 79.17%;In venlafaxine-treated patients,the positive and negative predictive value of the early improvement at week 1 were 84.62%and 65.33%,and that at week 2 were 59.21%and 88.00%,respectively.Conclusion The early improvement achieved within the first week of escitalopram or venlafaxine treatment can predict a good 8-week treatment outcome in GAD patients.
引文
1.Bereza BG,Machado M,Ravindran AV,Einarson TR.evidence-based review of clinical outcomes of guideline recommended pharmacotherapies for generalized anxiety disorder.Can J Psychiatry.2012;57(8):470-478.
2.Baldwin DS,Waldman S,Allgulander C.Evidence-based pharmacological treatment of generalized anxiety disorder.Int J Neuropsychopharmacol.2011;14(5):697-710.3
3.Excellence NIfHaC.Generalised anxiety disorder and panic disorder(with or without agoraphobia)in adults:management in primary,secondary,and community care.NICE clinical guideline.2011:Available from:www.nice.org.uk/nicemedia/live/12147/51542/51542.pdf.
4.Western Australian Psychotropic Drugs Committee-WAPDC.Anxiety Disorders Drug Treatment Guidelines.2008:Available from:www.health.wa.gov.au/docreg/Education/Population/Health_Problems/HP010922_anxiety_disorders.pdf
5 Stahl SM.Stahl's essential psychopharmacology neuroscientic basis and practical application.3rd edt.New York:Cambridge University Press;2008.
6 Baldwin DS,Schweizer E,Xu Y,Lyndon G.Does early improvement predict endpoint response in patients with generalized anxiety disorder(GAD)treated with pregabalin or venlafaxine XR?Eur Neuropsychopharmacol.2012;22(2):137-142.
7.Whalen PJ,Johnstone T,Somerville LH,et al.A functional magnetic resonance imaging predictor of treatment response to venlafaxine in generalized anxiety disorder.Biol Psychiatry.2008;63(9):858-863.
8.Hoehn-Saric R,Schlund MW,Wong SH.Effects of citalopram on worry and brain activation in patients with generalized anxiety disorder.Psychiatry Res.2004;131(1):11-21.
9.Nitschke JB,Sarinopoulos I,Oathes DJ,et al.Anticipatory activation in the amygdala and anterior cingulate in generalized anxiety disorder and prediction of treatment response.Am J Psychiatry.2009;166(3):302-310.
10.Cook IA,Leuchter AF,Morgan M,et al.Early changes in prefrontal activity characterize clinical responders to antidepressants.Neuropsychopharmacology.2002,27(1):120-131.
11.,Park YM,Kim DW,Kim S,Im CH,Lee SH.The loudness dependence of the auditory evoked potential(LDAEP)as a predictor of the response to escitalopram in patients with generalized anxiety disorder.Psychopharmacology(Berl).2011;213(2-3):625-32.
12.Perlis RH,Fijal B,Dharia S,Houston JP..Pharmacogenetic investigation of response to duloxetine treatment in generalized anxiety disorder.Pharmacogenomics J.2013;13(3):280-5.
13.Cooper AJ,Narasimhan S,Rickels K,Lohoff FW.Genetic polymorphisms in the PACAP and PAC1 receptor genes and treatment response to venlafaxine XR in generalized anxiety disorder.Psychiatry Res.2013;210(3):1299-300.
14.Cooper AJ,Rickels K,Lohoff FW.Association analysis between the A118G polymorphism in the 0PRM1 gene and treatment response to venlafaxine XR in generalized anxiety disorder.Hum Psychopharmacol.2013;28(3):258-262.
15.Lohoff FW,Narasimhan S,Rickels K.Interaction between polymorphisms in serotonin transporter(SLC6A4)and serotonin receptor 2A(HTR2A)genes predict treatment response to venlafaxine XR in generalized anxiety disorder.Pharmacogenomics J.2013;13(5):464-469.
16.Olatunji BO,Feldman G,Smits JA,et al.Examination of the decline in symptoms of anxiety and depression in generalized anxiety disorder:impact of anxiety sensitivity on response to pharmacotherapy.Depress Anxiety.2008;25(2):167-171.
17.Pollack MH,Meoni P,Otto MW,Simon N,Hackett D.Predictors of outcome following venlafaxine extended-release treatment of DSM-IV generalized anxiety disorder:a pooled analysis of short-and long-term studies.J Clin Psychopharmacol.2003;23(3):250-259.
18.Joesch JM,Golinelli D,Sherbourne CD,et al.Trajectories of change in anxiety severity and impairment during and after treatment with evidence-based treatment for multiple anxiety disorders in primary care.Depress Anxiety.2013;30(11):1099-1106.
19.Compton SN,Peris TS,Almirall D,et al.Predictors and Moderators of Treatment Response in Childhood Anxiety Disorders:Results From the CAMS Trial.J Consult Clin Psychol.2014;82(2):212-224
20.Pollack MH,Kornstein SG,Span Crits-Christoph P,Raskin J,Russell JM.Early improvement during duloxetine treatment of generalized anxiety disorder predicts response and remission at endpoint.J Psychiatr Res.2008,42(14):1176-1184.
21.Rynn M,Khalid-Khan S,Garcia-Espana JF,Etemad B,Rickels K..Early response and 8-week treatment outcome in GAD.Depress Anxiety.2006;23(8):461-465.
22.Szegedi A,Jansen WT,van Willigenburg AP,van der Meulen E,Stassen HH,Thase ME..Early improvement in the first 2weeks as a predictor of treatment outcome in patients with major depressive disorder:a meta-analysis including 6562 patients.J Clin Psychiatry.2009,70(3):344-353.
2.Baldwin DS,Waldman S,Allgulander C.Evidence-based pharmacological treatment of generalized anxiety disorder.Int J Neuropsychopharmacol.2011;14(5):697-710.3
3.Excellence NIfHaC.Generalised anxiety disorder and panic disorder(with or without agoraphobia)in adults:management in primary,secondary,and community care.NICE clinical guideline.2011:Available from:www.nice.org.uk/nicemedia/live/12147/51542/51542.pdf.
4.Western Australian Psychotropic Drugs Committee-WAPDC.Anxiety Disorders Drug Treatment Guidelines.2008:Available from:www.health.wa.gov.au/docreg/Education/Population/Health_Problems/HP010922_anxiety_disorders.pdf
5 Stahl SM.Stahl's essential psychopharmacology neuroscientic basis and practical application.3rd edt.New York:Cambridge University Press;2008.
6 Baldwin DS,Schweizer E,Xu Y,Lyndon G.Does early improvement predict endpoint response in patients with generalized anxiety disorder(GAD)treated with pregabalin or venlafaxine XR?Eur Neuropsychopharmacol.2012;22(2):137-142.
7.Whalen PJ,Johnstone T,Somerville LH,et al.A functional magnetic resonance imaging predictor of treatment response to venlafaxine in generalized anxiety disorder.Biol Psychiatry.2008;63(9):858-863.
8.Hoehn-Saric R,Schlund MW,Wong SH.Effects of citalopram on worry and brain activation in patients with generalized anxiety disorder.Psychiatry Res.2004;131(1):11-21.
9.Nitschke JB,Sarinopoulos I,Oathes DJ,et al.Anticipatory activation in the amygdala and anterior cingulate in generalized anxiety disorder and prediction of treatment response.Am J Psychiatry.2009;166(3):302-310.
10.Cook IA,Leuchter AF,Morgan M,et al.Early changes in prefrontal activity characterize clinical responders to antidepressants.Neuropsychopharmacology.2002,27(1):120-131.
11.,Park YM,Kim DW,Kim S,Im CH,Lee SH.The loudness dependence of the auditory evoked potential(LDAEP)as a predictor of the response to escitalopram in patients with generalized anxiety disorder.Psychopharmacology(Berl).2011;213(2-3):625-32.
12.Perlis RH,Fijal B,Dharia S,Houston JP..Pharmacogenetic investigation of response to duloxetine treatment in generalized anxiety disorder.Pharmacogenomics J.2013;13(3):280-5.
13.Cooper AJ,Narasimhan S,Rickels K,Lohoff FW.Genetic polymorphisms in the PACAP and PAC1 receptor genes and treatment response to venlafaxine XR in generalized anxiety disorder.Psychiatry Res.2013;210(3):1299-300.
14.Cooper AJ,Rickels K,Lohoff FW.Association analysis between the A118G polymorphism in the 0PRM1 gene and treatment response to venlafaxine XR in generalized anxiety disorder.Hum Psychopharmacol.2013;28(3):258-262.
15.Lohoff FW,Narasimhan S,Rickels K.Interaction between polymorphisms in serotonin transporter(SLC6A4)and serotonin receptor 2A(HTR2A)genes predict treatment response to venlafaxine XR in generalized anxiety disorder.Pharmacogenomics J.2013;13(5):464-469.
16.Olatunji BO,Feldman G,Smits JA,et al.Examination of the decline in symptoms of anxiety and depression in generalized anxiety disorder:impact of anxiety sensitivity on response to pharmacotherapy.Depress Anxiety.2008;25(2):167-171.
17.Pollack MH,Meoni P,Otto MW,Simon N,Hackett D.Predictors of outcome following venlafaxine extended-release treatment of DSM-IV generalized anxiety disorder:a pooled analysis of short-and long-term studies.J Clin Psychopharmacol.2003;23(3):250-259.
18.Joesch JM,Golinelli D,Sherbourne CD,et al.Trajectories of change in anxiety severity and impairment during and after treatment with evidence-based treatment for multiple anxiety disorders in primary care.Depress Anxiety.2013;30(11):1099-1106.
19.Compton SN,Peris TS,Almirall D,et al.Predictors and Moderators of Treatment Response in Childhood Anxiety Disorders:Results From the CAMS Trial.J Consult Clin Psychol.2014;82(2):212-224
20.Pollack MH,Kornstein SG,Span Crits-Christoph P,Raskin J,Russell JM.Early improvement during duloxetine treatment of generalized anxiety disorder predicts response and remission at endpoint.J Psychiatr Res.2008,42(14):1176-1184.
21.Rynn M,Khalid-Khan S,Garcia-Espana JF,Etemad B,Rickels K..Early response and 8-week treatment outcome in GAD.Depress Anxiety.2006;23(8):461-465.
22.Szegedi A,Jansen WT,van Willigenburg AP,van der Meulen E,Stassen HH,Thase ME..Early improvement in the first 2weeks as a predictor of treatment outcome in patients with major depressive disorder:a meta-analysis including 6562 patients.J Clin Psychiatry.2009,70(3):344-353.