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Fluvoxamine-controlled release formulation for the treatment of generalized social anxiety disorder
Jonathan Davidson1, Jose Yaryura-Tobias, Robert DuPont
1Department of Psychiatry, Duke University Medical Center, Trent Drive, 4th Floor, Room 4082B, Durham, NC 27710, USA. jonathan.davidson@duke.edu
Background:
Generalized social anxiety disorder is a highly prevalent anxiety disorder with deleterious effects on social and family relationships, as well as work performance. We report the results of a multicenter, randomized, placebo-controlled trial comparing the efficacy, safety, and tolerability of fluvoxamine controlled release (CR) to placebo in patients with generalized social anxiety disorder.
Methods:
A total of 279 adult patients meeting all inclusion/exclusion criteria was recruited at 23 United States sites and randomly assigned to receive either fluvoxamine CR (100-300 mg/d) or placebo for 12 weeks. The dose could be increased, based on efficacy and tolerability, in increments of 50 mg/d at weekly intervals. The dosage remained constant during weeks 6 to 12.
Results:
Treatment with fluvoxamine CR resulted in statistically and clinically significant improvements in symptoms associated with generalized social anxiety disorder as early as week 4 on the Liebowitz Social Anxiety Scale and the Clinical Global Impression Scale Global Improvement, and at week 6 on the Sheehan Disability Scale, Clinical Global Impression Scale Severity of Illness and the Patient Global Impression of Improvement Scale. The most frequent adverse events reported by patients on fluvoxamine CR were headache, nausea, somnolence, and insomnia. No weight gain was observed for either treatment group, and at end point, there were no differences between treatments on overall sexual function, as measured by the Arizona Sexual Experience Scale.
Conclusions:
Both physician and patient-rated scales indicate that fluvoxamine CR is effective and safe for the treatment of generalized social anxiety disorder.
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Generalized Anxiety Disorder
Social Anxiety Disorder
Anxiolytic Drugs: Overview
Primary Types of Anxiolytic Drugs
1. Benzodiazepines:
Benzodiazepines bind to the GABA-A receptor in the brain, enhancing GABA's interaction. This action reduces neurotransmission, effectively blocking anxiety-associated limbic circuitry.
Anxiolytic Drugs: Benzodiazepines and Buspirone
Antidepressant Drugs: MAOIs and Other Agents
Oral Drug Delivery Systems: Continuous-Release Systems