Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-25T09:18:14.326Z Has data issue: false hasContentIssue false
  • English
  • Français

Social adjustment in generalised anxiety disorder: a long-term placebo-controlled study of venlafaxine extended release

Published online by Cambridge University Press:  16 April 2020

Patrice Boyer ,
Vincent Mahé  and
David Hackett
Patrice Boyer*
Affiliation:
CNRS UMR 7593, Hôpital de la Pitié-Salpêtrière, 47, Boulevard de L’Hôpital, 75651Paris, France
Vincent Mahé
Affiliation:
Service de Psychiatrie, Hôpital General de Meaux, France
David Hackett
Affiliation:
Wyeth Research, Paris, France
*
*Corresponding author.
Get access

Abstract

The objective of this analysis was to evaluate the short- (8 weeks) and long-term (24 weeks) efficacy of three fixed doses of venlafaxine extended release (ER) and placebo on the social adjustment of patients with generalised anxiety disorder (GAD). We analysed data from 544 outpatients who participated in a 24-week, double-blind, multicentre, parallel-group, placebo-controlled study conducted at 55 centres in five countries. All patients meet the DSM-IV criteria for GAD and were randomly assigned to receive venlafaxine ER 37.5, 75, and 150 mg or matched placebo administered orally once daily. Social adjustment was measured using the Social Adjustment Scale-Self Report, which explores social adaptation in the areas of work, social and leisure, extended family, primary relationship (marital), parental, and family unit. At baseline, the GAD patients had a high level of social dysfunction. Venlafaxine ER showed a dose-related improvement in social impairment during short-term treatment and in sustaining this improvement over the long-term. In the most severely socially impaired subgroup, placebo remission rates on the HAM-A were low, and the magnitude of the venlafaxine-placebo difference on the mean HAM-A total score was high, reaching more than 7 points. The benefits of venlafaxine ER treatment of GAD extend beyond that of improvement of anxiety symptoms to a significant improvement in the impairment of functioning that is associated with the illness.

Keywords

Generalised anxiety disorderSocial impairmentVenlafaxine
Type
Original article
Information
European Psychiatry , Volume 19 , Issue 5 , August 2004 , pp. 272 - 279
Copyright
Copyright © 2004 European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allgulander, CHackett, DSalinas, EVenlafaxine extended release (ER) in the treatment of generalised anxiety disorder: twenty-four-week placebo-controlled dose-ranging study. Br J Psychiatry 2001;179:15–22.CrossRefGoogle ScholarPubMed
American Psychiatric Association. DSM-IV: diagnostic and statistical manual of mental disorders. 4th ed. Washington (DC): American Psychiatric Association; 1994.Google Scholar
Anderson, DJNoyes, R JrCrowe, RRA comparison of panic disorder and generalized anxiety disorder. Am J Psychiatry 1984;141:572–5.Google ScholarPubMed
Andrews, JMNinan, PTNemeroff, CBVenlafaxine: a novel antide-pressant that has a dual mechanism of action. Depression 1996;4:48–56.3.0.CO;2-B>CrossRefGoogle Scholar
Barlow, DHBlanchard, EBVermilyea, JAVermilyea, BBDiNardo, PAGeneralized anxiety and generalized anxiety disorder: description and reconceptualisation. Am J Psychiatry 1986;143:40–4.Google Scholar
Davidson, JRDuPont, RLHedges, DHaskins, JTEfficacy, safety, and tolerability of venlafaxine extended release and buspirone in outpatients with generalized anxiety disorder. J Clin Psychiatry 1999;60: 528–35.CrossRefGoogle ScholarPubMed
Faravelli, CGuerrini Degl’Innocenti, BGiardinelli, L.Epidemiology of anxiety disorders in Florence. Acta Psychiatr Scand 1989;79:308–12.CrossRefGoogle ScholarPubMed
Gelenberg, AJLydiard, RBRudolph, RLAguiar, LHaskins, JTSalinas, EEfficacy of venlafaxine extended-release capsules in non-depressed outpatients with generalized anxiety disorder: a 6-month randomized controlled trial. JAMA 2000;283:3082–8.CrossRefGoogle Scholar
Guy, WNational Institute of Mental Health (US). Psychopharmacology Research Branch. Early Clinical Drug Evaluation Program. ECDEU assessment manual for psychopharmacology. Rockville, MD: U.S. Dept. of Health, Education, and Welfare, Public Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, Psychopharmacology Research Branch, Division of Extramural Research Programs; 1976 Revised ed.Google Scholar
Hamilton, MThe assessment of anxiety states by rating. Br J Med Psychol 1959;32:50–5.CrossRefGoogle ScholarPubMed
Keller, MRole of serotonin and noradrenaline in social dysfunction: a review of data on reboxetine and the Social Adaptation Self-evaluation Scale (SASS). Gen Hospital Psychiatry 2001;23:15–9.CrossRefGoogle Scholar
Kessler, RCFrank, RGThe impact of psychiatric disorders on work loss days. Psychol Med 1997;27:861–73.CrossRefGoogle ScholarPubMed
Kessler, RCMcGonagle, KAZhao, SNelson, CBHughes, MEshleman, Set al.Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comor-bidity Survey. Arch Gen Psychiatry 1994;51:8–19.CrossRefGoogle Scholar
Khan, AUpton, GVRudolph, RLEntsuah, RLeventer, SMThe use of venlafaxine inthe treatment of major depression and major depression associated with anxiety: a dose–response study. J Clin Psychopharmacol 1998;18:19–25.CrossRefGoogle Scholar
Leaf, PJWeissman, MMMyers, JKTischler, GLHolzer 3d CE. Social factors related to psychiatric disorder: the Yale Epidemiologic Catchment Area study. Soc Psychiatry 1984;19:53–61.CrossRefGoogle Scholar
Luty, SEJoyce, PRMulder, RTComparison between noradrenergic and serotonergic medications using the social adjustment scale: is drive enhancement necessary for recovery of social functioning? J Psychopharmacol 2001;15:257–64.Google ScholarPubMed
Noyes, R JrClarkson, CCrowe, RRYates, WRMcChesney, CMA family study of generalized anxiety disorder. Am J Psychiatry 1987;144:1019–24.Google ScholarPubMed
Pollack, MHZaninelli, RGoddard, AMcCafferty, JPBellew, KMBurnham, DBet al.Paroxetine in the treatment of generalized anxiety disorder: results of a placebo-controlled, flexible-dosage trial. J Clin Psychiatry 2001;62:350–7.CrossRefGoogle ScholarPubMed
Rickels, KAntianxiety therapy: potential value of long-term treatment. J Clin Psychiatry 1987;48:7–11.Google ScholarPubMed
Rickels, KDowning, RSchweizer, EHassman, HAntidepressants for the treatment of generalized anxiety disorder. A placebo-controlled comparison of imipramine, trazodone, and diazepam. Arch Gen Psychiatry 1993;50:884–95.Google ScholarPubMed
Rickels, KPollack, MHSheehan, DVHaskins, JTEfficacy of extended-release venlafaxine in nondepressed outpatients with generalized anxiety disorder. Am J Psychiatry 2000;157:968–74.Google ScholarPubMed
Rickels, KSchweizer, EThe clinical course and long-term management of generalized anxiety disorder. J Clin Psychopharmacol 1990;10:101S–10S.CrossRefGoogle ScholarPubMed
Robins, LNRegier, DA editors. Psychiatric disorders in America: the epidemiologic catchment area study. NewYork, NY: Free Press; 1991.Google Scholar
Souetre, ELozet, HCimarosti, IMartin, PChignon, JMAdes, Jet al.Cost of anxiety disorders: impact of comorbidity. J Psychosom Res 1994;38:151–60.CrossRefGoogle ScholarPubMed
Tse, WSBond, AJDifference in serotonergic and noradrenergic regulation of human social behaviours. Psychopharmacol 2002;159: 216–21.CrossRefGoogle ScholarPubMed
Üstün, TBSartorius, N editors. Mental illness in general health care: an international study. Chichester, NY: Wiley; 1995.Google Scholar
van Praag, HMAsnis, GMKahn, RSet al.Mono-amines and abnormal behaviour. A multi-aminergic perspective. Br J Psychiatry 1990; 157:723–34.CrossRefGoogle Scholar
Wacker, HRMullejans, RKlein, KHBattegay, RIdentification of cases of anxiety disorders and affective disorders in the community according to ICD-10 and DSM-III-R by using the Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 1992;2:91–100.Google Scholar
Weissman, MStaff, MHSSAS-SR social adjustment scale self-report technical manual. 1999.Google Scholar
Weissman, MMBothwell, SAssessment of social adjustment by patient self-report. Arch Gen Psychiatry 1976;33:1111–5.CrossRefGoogle ScholarPubMed
Weissman, MMPrusoff, BAThompson, WDHarding, PSMyers, JKSocial adjustment by self-report in a community sample and in psychiatric outpatients. J Nerv Ment Dis 1978;166:317–26.CrossRefGoogle Scholar
Wittchen, HUZhao, SKessler, RCEaton, WWDSM-III-R generalized anxiety disorder in the National Comorbidity Survey. Arch Gen Psychiatry 1994;51:355–64.CrossRefGoogle ScholarPubMed
Yonkers, KAWarshaw, MGMassion, AOKeller, MBPhenomenology and course of generalised anxiety disorder. Br J Psychiatry 1996; 168:308–13.CrossRefGoogle ScholarPubMed
Zigmond, ASSnaith, RPThe hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–70.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.