Efficacy and safety of duloxetine in the treatment of generalized anxiety disorder: a flexible-dose, progressive-titration, placebo-controlled trial

Feb 22, 2007Depression and anxiety

Duloxetine’s safety and effectiveness for treating generalized anxiety disorder in a flexible-dose study compared to placebo

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Abstract

In a 10-week trial involving 327 adults with generalized anxiety disorder, duloxetine treatment led to significantly greater improvements in anxiety and functioning compared to placebo.

Duloxetine-treated patients showed a significant reduction in Hamilton Anxiety Scale (HAMA) total scores (P=.02).
The response rate for duloxetine was higher, with a greater than 50% reduction in HAMA scores (P=.03).
Improvements in global functioning and impairment scores on the Sheehan Disability Scale (SDS) were significantly better for duloxetine recipients (P<.01).
Adverse events were more common in the duloxetine group, with a higher discontinuation rate due to these events (P=.002).
Common side effects associated with duloxetine included nausea, dizziness, and somnolence.

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Generalized anxiety disorder (GAD), a prevalent and chronic illness, is associated with dysregulation in both serotonergic and noradrenergic neurotransmission. Our study examined the efficacy, safety, and tolerability of duloxetine hydrochloride, a dual reuptake inhibitor of serotonin and norepinephrine, for short-term treatment of adults with GAD. In a 10-week, double-blind, progressive-titration, flexible-dose trial, 327 adult outpatients with a DSM-IV-defined GAD diagnosis were randomized to duloxetine 60-120 mg (DLX, N=168) or placebo (PLA, N=159) treatment. The primary efficacy measure was mean change from baseline to endpoint in Hamilton Anxiety Scale (HAMA) total score. Secondary outcome measures included response rate (HAMA total score reduction > or =50% from baseline), Clinician Global Impression-Improvement (CGI-I) scores, and Sheehan Disability Scale (SDS) scores. Patients who received duloxetine treatment demonstrated significantly greater improvement in HAMA total scores (P=.02); a higher response rate (P=.03), and greater improvement (P=.04) than patients who received placebo. Duloxetine-treated patients were also significantly more improved than placebo-treated patients on SDS global functional (P<.01) and work, social, and family/home impairment scores (P<.05). The rate of discontinuation due to adverse events (AEs) was higher for the duloxetine group compared with the placebo group (P=.002). The AEs most frequently associated with duloxetine were nausea, dizziness, and somnolence. Duloxetine was an efficacious, safe, and well-tolerated treatment that resulted in clinically significant improvements in symptom severity and functioning for patients with GAD.

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Efficacy and safety of duloxetine in the treatment of generalized anxiety disorder: a flexible-dose, progressive-titration, placebo-controlled trial

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