Rickels K, Pollack M H, Sheehan D V, Haskins J T
Psychopharmacology Unit, University Science Center, University of Pennsylvania 19104-2649, USA.
Am J Psychiatry. 2000 Jun;157(6):968-74. doi: 10.1176/appi.ajp.157.6.968.
This study evaluated the efficacy and safety of fixed doses of once-daily extended-release (XR) venlafaxine in outpatients with generalized anxiety disorder without concomitant major depressive disorder.
Adult outpatients with generalized anxiety disorder but not major depressive disorder with total scores of 18 or higher on the Hamilton Rating Scale for Anxiety and scores of 2 or higher on its anxious mood and tension factors were eligible. Patients were randomly assigned to receive placebo or venlafaxine XR (75, 150, or 225 mg/day) for 8 weeks. Primary efficacy variables were final total and psychic anxiety factor scores on the Hamilton anxiety scale and final severity and global improvement item scores on the Clinical Global Impression (CGI) scale.
Of the 377 patients entering the study, 370 were included in a safety analysis and 349 in an efficacy analysis. Adjusted mean scores at 8 weeks (last-observation-carried-forward analysis) were significantly lower for one or more of the venlafaxine XR groups in four of four primary and three of four secondary outcome measures than for the placebo group. These included a change of 1.7 (versus 1.3) from baseline on CGI severity item scores and a final score of 2.2 (versus 2.6) on the CGI global improvement item. All doses of venlafaxine XR were well tolerated.
Venlafaxine XR is an effective and well-tolerated option for the short-term treatment of generalized anxiety disorder in outpatients without major depressive disorder.
本研究评估了固定剂量的每日一次缓释文拉法辛治疗无伴发重度抑郁症的广泛性焦虑症门诊患者的疗效和安全性。
入选标准为患有广泛性焦虑症但无重度抑郁症、汉密尔顿焦虑量表总分18分或更高且焦虑情绪和紧张因子得分2分或更高的成年门诊患者。患者被随机分配接受安慰剂或文拉法辛缓释剂(75、150或225毫克/天)治疗8周。主要疗效变量为汉密尔顿焦虑量表的最终总分和精神焦虑因子得分,以及临床总体印象量表的最终严重程度和总体改善项目得分。
377名进入研究的患者中,370名纳入安全性分析,349名纳入疗效分析。在四项主要结局指标中的四项以及四项次要结局指标中的三项中,文拉法辛缓释剂组中一个或多个组在8周时(末次观察结转分析)的调整后平均得分显著低于安慰剂组。这些指标包括临床总体印象严重程度项目得分较基线变化1.7(对比1.3)以及临床总体印象总体改善项目最终得分为2.2(对比2.6)。所有剂量的文拉法辛缓释剂耐受性良好。
文拉法辛缓释剂是治疗无重度抑郁症的广泛性焦虑症门诊患者的一种有效且耐受性良好的短期治疗选择。