Display options
Cite
Hartford JT, Endicott J, Kornstein SG, et al. Implications of pain in generalized anxiety disorder: efficacy of duloxetine. Prim Care Companion J Clin Psychiatry. 2008;10(3):197-204doi: 10.4088/pcc.v10n0304.
Hartford, J. T., Endicott, J., Kornstein, S. G., Allgulander, C., Wohlreich, M. M., Russell, J. M., Perahia, D. G., & Erickson, J. S. (2008). Implications of pain in generalized anxiety disorder: efficacy of duloxetine. Primary care companion to the Journal of clinical psychiatry, 10(3), 197-204. https://doi.org/10.4088/pcc.v10n0304
Hartford, James T, et al. "Implications of pain in generalized anxiety disorder: efficacy of duloxetine." Primary care companion to the Journal of clinical psychiatry vol. 10,3 (2008): 197-204. doi: https://doi.org/10.4088/pcc.v10n0304
Hartford JT, Endicott J, Kornstein SG, Allgulander C, Wohlreich MM, Russell JM, Perahia DG, Erickson JS. Implications of pain in generalized anxiety disorder: efficacy of duloxetine. Prim Care Companion J Clin Psychiatry. 2008;10(3):197-204. doi: 10.4088/pcc.v10n0304. PMID: 18615176; PMCID: PMC2446497.
Copy Download .nbib Format: NLM
Share it on

Prim Care Companion J Clin Psychiatry. 2008;10(3):197-204. doi: 10.4088/pcc.v10n0304.

Implications of pain in generalized anxiety disorder: efficacy of duloxetine.

Primary care companion to the Journal of clinical psychiatry

James T Hartford, Jean Endicott, Susan G Kornstein, Christer Allgulander, Madelaine M Wohlreich, James M Russell, David G S Perahia, Janelle S Erickson

Affiliations

  1. Hartford Research Group, Cincinnati, Ohio, USA. [email protected]

PMID: 18615176 PMCID: PMC2446497 DOI: 10.4088/pcc.v10n0304

Abstract

OBJECTIVE: To conduct a post hoc evaluation of the prevalence of clinically significant pain and the efficacy of duloxetine in patients with generalized anxiety disorder (GAD) and concurrent pain.

METHOD: Data from two 9- to 10-week double-blind, placebo-controlled, randomized clinical trials of duloxetine (60 to 120 mg) in DSM-IV-defined GAD were analyzed (study 1 was conducted from July 2004 to September 2005; study 2 was conducted from August 2004 to June 2005). Efficacy was assessed with the Hamilton Rating Scale for Anxiety (HAM-A), visual analog scales (VAS) for pain, the Hospital Anxiety Depression Scale (HADS), the Clinical Global Impressions-Improvement of Illness (CGI-I) scale, the Patient Global Impressions-Improvement (PGI-I) scale, and the Sheehan Disability Scale (SDS) global functional impairment scale.

RESULTS: Of 840 patients randomly assigned to treatment, 61.3% (302 duloxetine, 213 placebo) had VAS scores ≥ 30 mm on at least 1 of the pain scales, indicating clinically significant pain. Among those patients with concurrent pain at baseline, change from baseline to endpoint in the HAM-A total score (42.9% change in mean scores for duloxetine, 31.4% for placebo), HADS anxiety scale (40.3% vs. 22.8%), HADS depression scale (36.1% vs. 20.5%), HAM-A psychic factor (45.9% vs. 29.9%), and SDS global functional improvement score (45.5% vs. 22.1%) was significantly (all p's < .001) greater for duloxetine compared with placebo. Improvement on the CGI-I (p = .003) and PGI-I (p < .001) was also significantly greater for duloxetine. Response (HAM-A total score decrease ≥ 50%) (49% vs. 29%) and remission (HAM-A total score ≤ 7 at endpoint) (29% vs. 18%) rates were significantly greater for duloxetine compared with placebo (p < .001 and p = .041, respectively). Duloxetine demonstrated statistically significantly greater reduction in pain on all 6 VAS pain scales (all p's < .001 except headaches with p < .002) (for duloxetine, percent change in means from baseline to endpoint ranged from 40.1% to 45.2% across the 6 VAS scales; for placebo, 22.0% to 26.3%).

CONCLUSION: Duloxetine, relative to placebo, improves anxiety symptoms, pain, and functional impairment among patients with GAD with concurrent clinically significant pain.

TRIAL REGISTRATION: clinicaltrials.gov Identifiers: NCT00122824 (study 1) and NCT00475969 (study 2).

References

  1. Arthritis Rheum. 2004 Sep;50(9):2974-84 - PubMed
  2. Am Fam Physician. 2005 Feb 1;71(3):483-90 - PubMed
  3. Depress Anxiety. 2003;17(3):173-9 - PubMed
  4. Arch Gen Psychiatry. 2005 Jun;62(6):593-602 - PubMed
  5. J Clin Psychiatry. 1999;60 Suppl 22:29-34 - PubMed
  6. J Psychiatr Res. 2005 Jan;39(1):43-53 - PubMed
  7. J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57 - PubMed
  8. J Nerv Ment Dis. 1969 Jan;148(1):87-98 - PubMed
  9. Anesth Analg. 1998 Jan;86(1):102-6 - PubMed
  10. Psychopharmacology (Berl). 2005 Nov;182(4):551-61 - PubMed
  11. Acta Psychiatr Scand. 2006 Jun;113(6):492-500 - PubMed
  12. Arch Gen Psychiatry. 2005 Jun;62(6):617-27 - PubMed
  13. Psychosomatics. 2004 Jan-Feb;45(1):17-28 - PubMed
  14. Proc Annu Meet Am Psychopathol Assoc. 1976;(64):178-218 - PubMed
  15. J Pharmacol Exp Ther. 2005 Feb;312(2):726-32 - PubMed
  16. Pain. 2005 Jul;116(1-2):109-18 - PubMed
  17. Psychosom Med. 2004 Jan-Feb;66(1):17-22 - PubMed
  18. Pain. 2003 Nov;106(1-2):127-33 - PubMed
  19. Acta Psychiatr Scand. 1983 Jun;67(6):361-70 - PubMed
  20. Arch Gen Psychiatry. 1990 Sep;47(9):849-53 - PubMed
  21. Pain. 2005 Dec 15;119(1-3):5-15 - PubMed
  22. Headache. 2005 Feb;45(2):144-52 - PubMed
  23. Psychol Med. 2005 Dec;35(12):1747-59 - PubMed
  24. Pain. 2001 Nov;94(2):149-158 - PubMed
  25. Br J Med Psychol. 1959;32(1):50-5 - PubMed
  26. Depress Anxiety. 2008;25(3):182-9 - PubMed
  27. Pain. 2004 Aug;110(3):697-706 - PubMed
  28. Depress Anxiety. 2002;16(4):162-71 - PubMed
  29. Int Clin Psychopharmacol. 2006 Nov;21(6):311-7 - PubMed
  30. J Clin Psychiatry. 2002;63 Suppl 8:24-34 - PubMed
  31. Pain. 2004 Sep;111(1-2):77-83 - PubMed
  32. Am J Psychiatry. 1999 Dec;156(12):1915-23 - PubMed
  33. J Clin Psychiatry. 1996;57 Suppl 7:86-91 - PubMed
  34. Hum Psychopharmacol. 2004 Oct;19 Suppl 1:S21-5 - PubMed
  35. Am J Psychiatry. 2001 Jun;158(6):892-8 - PubMed
  36. Brain Res. 1997 Dec 5;778(1):34-42 - PubMed
  37. Pain. 1997 Aug;72(1-2):95-7 - PubMed

Publication Types