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Escitalopram modestly improves generalised anxiety disorder in older adults in treatment completers

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QUESTION

Question:

Is escitalopram an effective, tolerable and safe treatment for generalised anxiety disorder in older adults?

Patients:

179 older adults (⩾60 years old) with a primary diagnosis of generalised anxiety disorder (GAD; DSM-IV criteria) and a Hamilton Anxiety Rating Scale (HAM-A) score ⩾17. Main exclusions: current antidepressant or anxiolytic use (up to 2 mg/day lorazepam equivalent was allowed); psychotic or bipolar disorder; current suicidal ideation; unstable medical condition; and current psychotherapy.

Setting:

Primary care and other outpatient clinics, Pittsburgh, Pennsylvania, USA; January 2005 to January 2008.

Intervention:

Escitalopram (10 mg/day with an increase to 20 mg/day allowed after 4 weeks depending on clinical response) or placebo for 12 weeks.

Outcomes:

Primary efficacy measure: response (Clinical Global Impressions Scale-Improvement (CGI-I) score of very much or much improved based on the assessor’s perception of improvement, anxiety scale scores and patient self-report). Secondary outcomes: HAM-A scale score, Penn State Worry Questionnaire, Late Life Function and Disability Instrument score, Medical Outcome Survey 36-item short form score (SF-36), patient reported adverse effects (open question).

Patient follow-up:

80.4% completed treatment, 98.9% included in analyses.

METHODS

Design:

Randomised controlled trial.

Allocation:

Concealed.

Blinding:

Double blind.

Follow-up period:

12 …

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Footnotes

  • Source of funding: National Institute of Health, Centre for Mental Health Services Research, and the Advanced Centre for Interventions and Services Research in Late-Life Mood Disorders; Forest Laboratories Inc (US patent holder for escitalopram) provided the study drug and placebo.

Footnotes

  • Competing interests: DS has received research grants and/or consultancy honoraria from Astrazeneca, Eli-Lilly, GlaxoSmithKline, Jazz Pharmaceuticals, Johnson & Johnson, Lundbeck, Orion, Pfizer, Pharmacia, Roche, Servier, Solvay, Sumitomo, Takeda, Tikvah and Wyeth.

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