Comparative efficacy of pregabalin and benzodiazepines in treating the psychic
and somatic symptoms of generalized anxiety disorder.
Author(s): Lydiard RB, Rickels K, Herman B, Feltner DE.
Affiliation(s): Psychiatry/Mental Health Ralph H. Johnson VA Medical Center, Charleston, SC
29401-5799, USA. lydiardb@mindyourhealth.net
Publication date & source: 2010, Int J Neuropsychopharmacol. , 13(2):229-41
Prior research suggests that SSRIs may have greater efficacy for psychic compared
to somatic anxiety, while benzodiazepines show greater somatic efficacy. The goal
of this analysis was to evaluate the efficacy of pregabalin (PGB) in treating
psychic and somatic symptoms of anxiety. Data were combined from six short-term,
double-blind, placebo-controlled, fixed-dose trials of PGB in patients with
generalized anxiety disorder (GAD). The following PGB daily dose groups were
studied: 150 mg (n=210), 300-450 mg (n=455), and 600 mg (n=406), benzodiazepines
(6 mg/d lorazepam and 1.5 mg/d alprazolam, n=299), vs. placebo (n=484). Changes
in Hamilton Anxiety Rating Scale (HAMA) psychic and somatic anxiety factors and
individual items were analysed. Treatment with 300-600 mg PGB significantly
improved both the HAMA psychic and somatic anxiety factors. In contrast,
treatment with 150 mg PGB appeared to be less effective, achieving significance
only on the psychic anxiety factor. PGB (300-450 mg) was associated with
significant improvement on 13 out of 14 HAMA items, while treatment with 600 mg
PGB was associated with significant improvement in 10 out of 14 HAMA items.
Treatment with benzodiazepines was also associated with significant improvement
in both psychic and somatic anxiety factors, with significant improvement
occurring in 5 out of 14 HAMA items. The results of this pooled analysis indicate
that both PGB and benzodiazepines had significant efficacy in treating both HAMA
psychic and somatic anxiety. A dose-response effect was evident for PGB that
reached a plateau at a dose of 300 mg/d.
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