Efficacy, safety, and tolerability of venlafaxine extended release and
buspirone in outpatients with generalized anxiety disorder
by
Davidson JR, DuPont RL, Hedges D, Haskins JT
Department of Psychiatry,
Duke University Medical Center,
Durham, NC 27710,
USA.
J Clin Psychiatry 1999 Aug; 60(8):528-35
ABSTRACT
BACKGROUND: The objective of this randomized, double-blind study was to
compare the efficacy and safety of venlafaxine extended release (XR) and
buspirone in outpatients with generalized anxiety disorder (GAD) but without
concomitant major depressive disorder. METHOD: Male and female outpatients at
least 18 years old who met the DSM-IV criteria for GAD and had scores of 18 or
higher on the Hamilton Rating Scale for Anxiety (HAM-A) were randomly assigned
to treatment with either venlafaxine XR (75 or 150 mg/day), buspirone (30 mg/day
in 3 divided doses), or placebo for 8 weeks. The primary efficacy variables were
changes in anxiety as determined by final on-therapy HAM-A total and psychic
anxiety scores and Clinical Global Impressions scale (CGI) scores. Other key
efficacy variables were HAM-A anxious mood and tension scores and the anxiety
subscale scores of the patient-rated Hospital Anxiety and Depression scale
(HAD). RESULTS: The efficacy analysis included 365 patients and the safety
analysis, 405. At week 8, adjusted mean HAM-A psychic anxiety, anxious mood, and
tension scores were significantly lower for venlafaxine XR-treated patients than
for placebo-treated patients. On the HAD anxiety subscale, venlafaxine XR, 75 or
150 mg/day, was significantly more efficacious than placebo at all time points
except weeks 1 (both dosages) and 2 (150-mg/day dosage only) and significantly
more efficacious than buspirone at all time points except week 1. On the
CGI-Improvement scale, scores for venlafaxine XR (both dosages) and buspirone
were numerically superior to those for placebo at all time points, and
statistical significance was observed at weeks 3, 4, 6, and 8 for venlafaxine XR
and at weeks 6 and 8 for buspirone. The adverse events were not essentially
different between treatment groups. CONCLUSION: Venlafaxine XR is an effective,
safe, and well-tolerated once-daily anxiolytic agent in patients with GAD
without comorbid major depressive disorder. This agent was significantly
superior to buspirone on the HAD anxiety subscale. Buspirone demonstrated
statistical significance versus placebo on a measure of anxiolytic response.
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