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Anxiously Awaited News: Antidepressant Effectively Relieves Symptoms of Anxiety Disorder

WebMD Health News

June 20, 2000 -- For the first time, researchers have shown that the antidepressant Effexor XR provides long-term relief from the disabling symptoms of generalized anxiety disorder. This is promising news to the millions of people in the United States who suffer from the condition.

Effexor XR had just received government approval in March as a treatment for generalized anxiety, but that approval was based on studies lasting only eight weeks. The new findings come from a six-month analysis that compares three different doses of the drug to placebo. The study results, published in this week's issue of the Journal of the American Medical Association, show that patients achieved a lasting benefit from Effexor XR. Overall, 69% of those on the drug had less anxiety, compared to 42% taking placebo.

It's estimated that generalized anxiety affects about 5% of the U.S. population, and about two-thirds of the patients are women. Symptoms, which can linger for six months or longer, include constant worry and anxiety about ordinary problems and often masquerade as physical problems, which is why many with generalized anxiety wind up getting treated by primary care physicians.

"[Generalized anxiety] is really a lifelong condition, and so in real life I suspect ... patients are going to be indefinitely on antidepressant treatment, much as there are people with chronic and recurring depression who stay on it forever," lead study researcher Alan Gelenberg, MD, of the University of Arizona Health Sciences Center, tells WebMD.

Gelenberg notes that using tranquilizers to control anxiety symptoms can lead to abuse, and some other antidepressants haven't been adequately tested or have limitations. Effexor XR increases the activity of two chemical messengers in the brain, norepinephrine and serotonin. That may account for the drug's ability to fight anxiety as well as depression.

"Despite the chronic nature of generalized anxiety, there are to date no published ... studies demonstrating that ... therapy provides long-term ... efficacy," write Gelenberg and colleagues. To prove this point, the investigators set up a six-month study in 14 medical facilities around the country. They divided approximately 250 patients into two groups -- one getting Effexor XR, the other dummy pills.

Participants were allowed to increase or decrease their dose as needed, depending on their reaction to the drug. About 20% of the patients in the trial suffered nausea, the most common side effect, and patients taking monoamine oxidase inhibitors for depression should avoid Effexor XR because of the danger of drug interaction.

At the end of study, which was sponsored by Wyeth-Ayerst, the drug's manufacturer, tests to measure anxiety showed that those taking Effexor XR were much improved over the six-month period. Although some patients had improvement in anxiety symptoms shortly after beginning to take the drug, the majority of patients experienced improvements after taking the drug for two months.

Stephen Stahl, MD, a professor of psychiatry at the University of California, San Diego, says that the study findings should send a clear message to generalized anxiety sufferers who may be tempted to give up early in treatment: "You can get much better from [generalized anxiety] ... if you wait."

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