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Re: The best Tricyclic for anxiety.... » torachan

Posted by SLS on May 29, 2008, at 5:16:03

In reply to Re: The best Tricyclic for anxiety.... » linkadge, posted by torachan on May 28, 2008, at 22:37:34

Hi.

I came upon a pretty convincing abstract on Medline demonstrating that, indeed, Linkadge and your doctor are right. There seemed to be no advantage to increasing the dosage beyond 75mg when treating generalized anxiety disorder (GAD).

What dosage of Seroquel is your doctor thinking of using?


- Scott


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1: Psychopharmacology (Berl). 2005 Jan;177(3):280-8. Epub 2004 Jul 16.Click here to read Links
Efficacy of low and higher dose extended-release venlafaxine in generalized social anxiety disorder: a 6-month randomized controlled trial.
Stein MB, Pollack MH, Bystritsky A, Kelsey JE, Mangano RM.

Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0985, USA. mstein@ucsd.edu

RATIONALE: There is a need for new pharmacological treatments for generalized social anxiety disorder (GSAD), which is a common, often disabling condition. OBJECTIVE: To compare the efficacy and safety over 6 months duration of two dose ranges of venlafaxine extended-release (ER) with placebo in patients with GSAD. METHOD: Twenty-eight-week, double-blind, multi-center study in 386 adult outpatients with DSM-IV GSAD. Patients were randomized to placebo, venlafaxine ER fixed low dose (75 mg/day), or venlafaxine ER flexible higher dose (150-225 mg/day). Primary efficacy variable was change on the Liebowitz Social Anxiety Scale (LSAS). Secondary efficacy variables included, among others, the proportion of responders on the CGI Global Improvement Item (score 1 or 2), and the proportion of remitters (defined as an LSAS score of <or=30). RESULTS: Improvement on the LSAS was greater with venlafaxine ER (at 75 mg/day or 150-225 mg/day) than placebo, and was sustained throughout the 6-month trial. Of patients receiving venlafaxine ER (at any dose), 58% responded to treatment compared to 33% of those receiving placebo (P<0.001); corresponding remission rates were 31% and 16% (P<0.01). There were no differences in outcome according to venlafaxine ER dosage. CONCLUSIONS: Venlafaxine ER was effective in the treatment of GSAD. The comparable efficacy at low and higher doses may indicate that norepinephrine reuptake blockade does not contribute to therapeutic effect in GSAD. This hypothesis should be tested using agents with specific actions on norepinephrine reuptake blockade.

 

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