Posted by Iansf on February 17, 2005, at 14:39:45
Topiramate evaluated
for generalized social phobiaTopiramate (Topamax) may have a role in the treatment of generalized social phobia, Canadian researchers report.
In a 16-week open-label study, 16 adult outpatients (7 males, 9 females) meeting the DSM-IV criteria for generalized social phobia were administered topiramate, 25 mg a day, slowly increased by 25 mg the first week, then increased by 50 mg increments for the following week, up to 100 mg a day at the end of week 3. At the end of week 5, the dose was further increased by 50 mg BID each week up to a maximum daily dose of 400 mg at week 9, depending on tolerability. Efficacy was determined by a Clinical Global Impression-Improvement Scale (CGI-I) score of 1 or 2 (very or much improved) at week 16, and by baseline-to-endpoint change in Liebowitz Social Anxiety Scale (LSAS) scores.
Eleven of 16 patients completed the trial, with five discontinuing the study due to adverse events or lack of efficacy. Among study completers (N=11), seven were considered responders at endpoint, as assessed by CGI-I and LSAS scores (mean drop of 41%). In the intent-to-treat analysis, seven patients were responders by CGI-I, and the mean drop in LSAS score was 29 percent. Repeated measures of analysis of variance (ANOVA) showed significant differences for self-reported measures of anxiety, but not for measures of generalized anxiety or depressive symptoms. The most commonly reported adverse events were weight loss, paresthesias and headache.
The researchers conclude, "topiramate may be effective in the treatment of generalized social phobia and an effective alternative to other drug treatments for [generalized social phobia], particularly for SSRIs." They note, "[topiramate] may have a very specific effect on reducing symptoms of social phobia but not on symptoms of generalized anxiety or depression."
Ameringen MV, Mancini C, Pipe B, et al.: An open trial of topiramate in the treatment of generalized social phobia. Poster presented at the 52nd annual meeting of the Canadian Psychiatric Association, Banff, November 2002.
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