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Efficacy of escitalopram in the treatment of social anxiety disorder: A meta-analysis versus placebo

Efficacy of escitalopram in the treatment of social anxiety disorder: A meta-analysis versus placebo
Efficacy of escitalopram in the treatment of social anxiety disorder: A meta-analysis versus placebo
Escitalopram is the most selective of the serotonin reuptake inhibitor (SSRI) antidepressants. We conducted a meta-analysis of placebo-controlled studies where escitalopram was used to treat patients with social anxiety disorder (SAD). Data from all randomised, double-blind placebo-controlled studies in SAD with escitalopram from both specialist settings and general practice were used. Patients met the DSM-IV criteria for SAD, ?18 years old, Liebowitz Social Anxiety Scale (LSAS) ?60. The primary outcome measure was the estimated treatment difference in LSAS total score at Week 12. Secondary outcome measures included the estimated treatment difference in the Clinical Global Impression-Severity (CGI-S) score at Week 12. A total of 1598 patients from 3 randomised controlled trials were included in the analyses. Escitalopram (n=1,061) was superior to placebo (n=537), with an estimated treatment difference on the LSAS of ?9.2 points (95%CI: [?14.4; ?4.0], p<0.01) (escitalopram 5 mg/day), ?4.6 points (95%CI: [?8.1; ?1.0], p<0.01) (escitalopram 10 mg/day), ?10.1 points (95%CI: [?13.7; ?6.5], p<0.01) (escitalopram 20 mg/day) and ?7.3 points (95%CI: [?12.3; ?2.2], p<0.01) (escitalopram 10-20 mg/day). For the CGI-S, the corresponding values were ?0.55 points (95%CI: [?0.79; ?0.31], p<0.01) (escitalopram 5 mg/day), ?0.26 points (95%CI: [?0.42; ?0.10], p<0.01) (escitalopram 10 mg/day), ?0.48 points (95%CI: [?0.64; ?0.31], p<0.01) (escitalopram 20 mg/day) and ?0.29 points (95%CI: [?0.51; ?0.07], p<0.05) (escitalopram 10-20 mg/day). The withdrawal rate due to adverse events was 7.2% for escitalopram, compared with 4.3% for placebo (p<0.05). In this meta-analysis, all doses of escitalopram showed significant superiority in efficacy versus placebo in the treatment of patients with SAD.
efficacy, escitalopram, social anxiety disorder, lsas, meta-analysis, placebo
0924-977X
1-21
Baldwin, D.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Asakura, S.
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Koyama, T.
013aa59a-9e90-411c-a4e6-3266223caee6
Hayano, T.
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Hagino, A.
e0a5d7fa-1213-4ab1-bca8-728362558c24
Reines, E.
114f701f-c10b-4780-8113-92a33e444b97
Larsen, K.
7b649f1d-f086-4c36-8f77-b9e915033e6b
Baldwin, D.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Asakura, S.
5ef7acc9-61ef-494e-9704-ded430a18e47
Koyama, T.
013aa59a-9e90-411c-a4e6-3266223caee6
Hayano, T.
a6eba0cd-9569-44d7-953d-78fce5962375
Hagino, A.
e0a5d7fa-1213-4ab1-bca8-728362558c24
Reines, E.
114f701f-c10b-4780-8113-92a33e444b97
Larsen, K.
7b649f1d-f086-4c36-8f77-b9e915033e6b

Baldwin, D., Asakura, S., Koyama, T., Hayano, T., Hagino, A., Reines, E. and Larsen, K. (2016) Efficacy of escitalopram in the treatment of social anxiety disorder: A meta-analysis versus placebo. European Neuropsychopharmacology, 1-21. (doi:10.1016/j.euroneuro.2016.02.013). (PMID:25932596)

Record type: Article

Abstract

Escitalopram is the most selective of the serotonin reuptake inhibitor (SSRI) antidepressants. We conducted a meta-analysis of placebo-controlled studies where escitalopram was used to treat patients with social anxiety disorder (SAD). Data from all randomised, double-blind placebo-controlled studies in SAD with escitalopram from both specialist settings and general practice were used. Patients met the DSM-IV criteria for SAD, ?18 years old, Liebowitz Social Anxiety Scale (LSAS) ?60. The primary outcome measure was the estimated treatment difference in LSAS total score at Week 12. Secondary outcome measures included the estimated treatment difference in the Clinical Global Impression-Severity (CGI-S) score at Week 12. A total of 1598 patients from 3 randomised controlled trials were included in the analyses. Escitalopram (n=1,061) was superior to placebo (n=537), with an estimated treatment difference on the LSAS of ?9.2 points (95%CI: [?14.4; ?4.0], p<0.01) (escitalopram 5 mg/day), ?4.6 points (95%CI: [?8.1; ?1.0], p<0.01) (escitalopram 10 mg/day), ?10.1 points (95%CI: [?13.7; ?6.5], p<0.01) (escitalopram 20 mg/day) and ?7.3 points (95%CI: [?12.3; ?2.2], p<0.01) (escitalopram 10-20 mg/day). For the CGI-S, the corresponding values were ?0.55 points (95%CI: [?0.79; ?0.31], p<0.01) (escitalopram 5 mg/day), ?0.26 points (95%CI: [?0.42; ?0.10], p<0.01) (escitalopram 10 mg/day), ?0.48 points (95%CI: [?0.64; ?0.31], p<0.01) (escitalopram 20 mg/day) and ?0.29 points (95%CI: [?0.51; ?0.07], p<0.05) (escitalopram 10-20 mg/day). The withdrawal rate due to adverse events was 7.2% for escitalopram, compared with 4.3% for placebo (p<0.05). In this meta-analysis, all doses of escitalopram showed significant superiority in efficacy versus placebo in the treatment of patients with SAD.

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Accepted/In Press date: 20 February 2016
e-pub ahead of print date: 27 February 2016
Keywords: efficacy, escitalopram, social anxiety disorder, lsas, meta-analysis, placebo
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 389377
URI: https://eprints.soton.ac.uk/id/eprint/389377
ISSN: 0924-977X
PURE UUID: fbe2c6b3-8048-4a97-8e96-618988aec19f

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Date deposited: 07 Mar 2016 12:07
Last modified: 15 Aug 2019 05:35

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