Randomized, placebo-controlled trial of quetiapine XR and divalproex ER monotherapies in the treatment of the anxious bipolar patient.

Background: Anxiety disorders complicate the treatment of bipolar disorder but are seldom the focus of bipolar treatment studies.

Methods: The anxiolytic effect of quetiapine XR 50-300 mg/day compared to divalproex ER (500-3000 mg/day) was tested in an 8-week, double-blind, placebo-controlled, randomized clinical trial in 149 patients with bipolar disorder and a co-occurring panic disorder or GAD. The primary efficacy measure was the Clinician Global Improvement-21 Anxiety Scale (CGI-21).

Assessing remission in major depressive disorder and generalized anxiety disorder clinical trials with the discan metric of the Sheehan disability scale.

Relatively little research has focused on the relationship between functional remission and symptomatic remission in mood and anxiety disorders. This study investigates the relationship and synchrony between symptomatic and functional remission in outpatients with major depressive disorder (MDD) and generalized anxiety disorder (GAD). Using data from three MDD (N=1419) and four GAD (N=1847) randomized, placebo-controlled duloxetine studies, we calculated the percentages of patients meeting symptomatic, functional, and combined functional-symptomatic remission criteria for each disorder.

Randomized, placebo-controlled trial of risperidone for acute treatment of bipolar anxiety.

Background: The treatment of bipolar disorder is often complicated by the presence of a co-occuring anxiety disorder. Although second generation antipsychotics are being used with increasing frequency in bipolar patients, their anxiolytic effects have not been well studied in this population.

Methods: The anxiolytic effect of risperidone 0.

Efficacy of print advertising for a bipolar disorder study.

Objective: Using quality and quantity of responses, this study evaluated the efficacy of advertising in print media for a bipolar disorder clinical trial.

Method: We analyzed the corresponding quantity of calls generated and the cost per patient yield at each of the standard study milestones, spending on print advertising. Quality of calls was based on the attrition rates at each of the study stages.

Assessing treatment effects in clinical trials with the discan metric of the Sheehan Disability Scale.

The Sheehan Disability Scale (SDS) is a patient-rated, discretized analog measure of functional disability in work, social, and family life. Its increasing use in clinical trials in psychiatry suggests a need to assess its responsiveness and interpretability. In this paper we identify and review studies in which the SDS was used as a treatment outcome measure.

An open-label study of tiagabine in panic disorder.

γ-aminobutyric acid (GABA) has been implicated in the pathophysiology of anxiety disorders, including panic. Tiagabine, a selective GABA reuptake inhibitor (SGRI), has been shown to reduce symptoms of anxiety. This pilot study evaluated the efficacy and safety of tiagabine in patients with panic disorder.

The speed of onset of action of alprazolam-XR compared to alprazolam-CT in panic disorder.

This study compares the speed of onset of action of the extended release (XR) formulation of alprazolam with that of the compressed tablet (CT) formulation in a sample of outpatients with DSM-IV panic disorder. Diary records of hourly antianxiety benefit from a 9-week open label switch study of 30-patients stabilized on alprazolam- CT for 3 weeks and then switched to an equivalent dose of alprazolam-XR, were used to examine the timing and magnitude of clinical benefit on both formulations. The magnitude of benefit at the first hour after the first morning dose was similar for both formulations.

Current approaches to the pharmacologic treatment of anxiety disorders.

Despite their high prevalence, the anxiety disorders are underdiagnosed and undertreated. Benzodiazepines, once the first line of treatment, have been superceded by SSRIs as the treatment of choice. Preclinical studies, however, suggest that CRF antagonists and antagonists of nicotinic,glutamate,5-HT1A,and NK-1 receptors may have potential anxiolytic action.

The Tourette's Disorder Scale (TODS): development, reliability, and validity.

To address the lack of a simple and standardized instrument to assess overall illness severity of Tourette's disorder (TD), the authors developed and tested a 15-item scale to measure a broad range of common symptoms including tics, inattention, hyperactivity, obsessions, compulsions, aggression, and emotional symptoms. Independent investigators used the 15-item Tourette's Disorder Scale (TODS) to assess 60 TD patients who were taking part in a double-blind placebo-controlled multicenter 8-week treatment study. Interrater reliability, internal consistency, convergent and discriminant validity, and sensitivity to change were examined.