Escitalopram in specific phobia: results of a placebo-controlled pilot trial

To assess the efficacy and safety of escitalopram in treating specific phobia.

The study was performed in an academic medical center. Adults meeting DSM-IV criteria for specific phobia were randomly assigned to 12 weeks of double-blind treatment with escitalopram or placebo. Efficacy measures included the Main Phobia Scale (MPS), the Marks Fear Questionnaire (FQ) and the Clinical Global Impressions of Improvement (CGI-I) scale. Data were collected between September 2002 and September 2004.

Of 13 subjects enrolled, 12 returned for at least one post-randomization visit and were included in the intent to treat sample. Response rates on the various subscales of the MPS and the FQ ranged from 20 to 80% for escitalopram, compared to 0-43% with placebo. Rates of response using the CGI-I scale were 60% for escitalopram and 29% for placebo, with a strong between treatment effect in favor of the drug at week 12 (effect-size = 1.13). Using the last observation carried forward, no statistically significant treatment differences were found. The drug was well tolerated.

Treatment response was consistently greater for escitalopram than for placebo, with strong effects observed in favor of the drug. However, treatment differences on the primary outcome measures were not significant in this under-powered pilot study. Escitalopram may hold promise as a treatment for specific phobia and larger randomized controlled trials are needed.