Escitalopram in the Treatment of Panic Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial
J Clin Psychiatry 2003;64:1322-1327
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Escitalopram, the therapeutically
active isomer of the racemic selective serotonin reuptake
inhibitor antidepressant citalopram, has shown significant
anxiolytic effects in placebo-controlled clinical trials of
social anxiety disorder, generalized anxiety disorder, and
anxiety symptoms associated with major depression. This study
evaluated the safety and efficacy of escitalopram in outpatients
diagnosed with panic disorder.
Method: Male and female outpatients between 18
and 80 years of age meeting DSM-IV criteria for panic disorder,
with or without agoraphobia, were randomly assigned to 10 weeks
of double-blind treatment with escitalopram, citalopram, or
placebo in a study conducted from September 1999 to July 2001.
The primary measure of efficacy was panic attack frequency at
week 10 relative to baseline, as assessed by the Modified Sheehan
Panic and Anticipatory Anxiety Scale.
Results: A total of 366 subjects (128
escitalopram patients, 119 citalopram patients, and 119 placebo
patients) received at least 1 dose of double-blind treatment. The
frequency of panic attacks was statistically significantly
improved (p = .04), and the increase in percentage of patients
with zero panic attacks reached borderline significance (p =
.051), in the escitalopram-treated group relative to the
placebo-treated group. Both escitalopram and citalopram
statistically significantly reduced panic disorder symptoms and
severity versus placebo at endpoint (p <= .05), as measured by
the Panic and Agoraphobia Scale total score, the Clinical Global
Impressions scale, the Patient Global Evaluation, and the Quality
of Life Enjoyment and Satisfaction Questionnaire. Treatment with
escitalopram was safe and well tolerated, with a similar
incidence of the most common adverse events for the escitalopram
and placebo groups. The rate of discontinuation for adverse
events was 6.3% for escitalopram, 8.4% for citalopram, and 7.6%
Conclusion: Escitalopram is efficacious,
safe, and well tolerated in the treatment of panic disorder.