Pregabalin augmentation of antidepressants in older patients with comorbid depression and generalized anxiety disorder—an open‐label study

Karaiskos, D.; Pappa, Dimitra; Tzavellas, Elias; Siarkos, Kostas; Katirtzoglou, Everina; Papadimitriou, George N.; Politis, Antonios

doi:10.1002/gps.3800

Cited by 28 publications

(8 citation statements)

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“…When considering the depression symptoms in our study, the confirmed reductions sustain the initial observations of a pooled post hoc analysis that reflected pregabalin reduced associated symptoms of depression despite its dose [ 47 ]. In agreement with our results, a recent open-label trial [ 48 ] found statistically significant reductions ( p < 0.001) in depression in older patients with GAD and comorbid depression from the fourth week of treatment. Global trends in amelioration of anxiety and depression outcomes were confirmed in our study by the significant change in the patient-reported Clinical Global Impression scale that benefits adjuvant pregabalin in GAD patients with partial response to SSRI with respect to UC ( p < 0.005).…”

Section: Discussionsupporting

confidence: 93%

Clinical and economic outcomes of adjunctive therapy with pregabalin or usual care in generalized anxiety disorder patients with partial response to selective serotonin reuptake inhibitors

et al. 2015

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BackgroundThis study is done to compare the effect of adjunctive therapy with pregabalin versus usual care (UC) on health-care costs and clinical and patients consequences in generalized anxiety disorder (GAD) subjects with partial response (PR) to a previous selective serotonin reuptake inhibitor (SSRI) course in medical practice in Spain.MethodsPost hoc analysis of patients with PR to SSRI monotherapy enrolled in a prospective 6-month naturalistic study was done. PR was defined as a Clinical Global Impression (CGI) scale score ≥3 and insufficient response with persistence of anxiety symptoms ≥16 in the Hamilton Anxiety Rating Scale (HAM-A). Two groups were analyzed: 1) adjunctive therapy (AT) with pregabalin (150–600 mg/day) to existing therapy and 2) UC (switching to a different SSRI or adding another anxiolytic different than pregabalin). Costs included GAD-related health-care resources utilization. Consequences were a combination of psychiatrist-based measurements [HAM-A, CGI, and Montgomery-Asberg Depression Rating Scale (MADRS)] and patient-reported outcomes [Medical Outcomes Study Sleep (MOS-sleep) scale, disability (World Health Organization Disability Assessment Schedule II (WHO-DAS II) and quality-of-life (Euro Qol-5D (EQ-5D)]. Changes in both health-care costs and scale scores were compared separately at end-of-trial visit by a general linear model with covariates.ResultsFour hundred eighty-six newly prescribed pregabalin and 239 UC GAD patients [mean (SD) HAM-A 26.7 (6.9) and CGI 4.1 (0.5)] were analyzed. Adding pregabalin was associated with significantly higher mean (95% CI) score reductions vs. UC in HAM-A [−14.9 (−15.6; −14.2) vs. −11.2 (−12.2; −10.2), p < 0.001] and MADRS [−11.6 (−12.2; −10.9) vs. −7.8 (−8.7; −6.8), p < 0.001]. Changes in all patient-reported outcomes favored significantly patients receiving pregabalin, including quality-of-life gain; 26.4 (24.7; 28.1) vs. 19.4 (17.1; 21.6) in the EQ-VAS, p < 0.001. Health-care costs were significantly reduced in both cohorts yielding similar 6-month costs; €1,565 (1,426; 1,703) pregabalin and €1,406 (1,200; 1,611) UC, p = 0.777. The effect of sex on costs and consequences were negligible.ConclusionIn medical practice, GAD patients with PR to SSRI experienced greater consequence improvements with adjunctive therapy with pregabalin versus UC, without increasing health-care cost. The effect of pregabalin was independent of patient gender.

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Section: Discussionsupporting

confidence: 93%

Clinical and economic outcomes of adjunctive therapy with pregabalin or usual care in generalized anxiety disorder patients with partial response to selective serotonin reuptake inhibitors

et al. 2015

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“…Previous uncontrolled studies suggested that pregabalin as add-on for anxiety in depression was as effective as benzodiazepines [99,100]. Until now, there were only open trials, 1 on GAD and depression in older adults [101] and another 2 on younger adults [102,103]. They both reported results similar in magnitude of effect with our study, but they were uncontrolled.…”

Section: Discussionsupporting

confidence: 67%

Efficacy of Add-on Pregabalin in the Treatment of Patients with Generalized Anxiety Disorder and Unipolar Major Depression With an Early Nonresponse to Escitalopram: A Double-Blind Placebo-Controlled Study

et al. 2018

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“…Pregabalin was also effective as adjunctive therapy in an open trial in older patients with comorbid GAD and depression [1355]. …”

Section: Special Populationsmentioning

confidence: 99%

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

et al. 2014

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BackgroundAnxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.MethodsThese guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.ResultsThese guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.ConclusionsAnxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.

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Pregabalin augmentation of antidepressants in older patients with comorbid depression and generalized anxiety disorder—an open‐label study

Abstract: The present study demonstrated a good therapeutic response to pregabalin in patients with depression comorbid with GAD after a 12-week treatment period. Both anxiety and depressive symptomatology significantly improved, and minimal side effects were observed.

Cited by 28 publications

References 20 publications

Clinical and economic outcomes of adjunctive therapy with pregabalin or usual care in generalized anxiety disorder patients with partial response to selective serotonin reuptake inhibitors

Clinical and economic outcomes of adjunctive therapy with pregabalin or usual care in generalized anxiety disorder patients with partial response to selective serotonin reuptake inhibitors

Efficacy of Add-on Pregabalin in the Treatment of Patients with Generalized Anxiety Disorder and Unipolar Major Depression With an Early Nonresponse to Escitalopram: A Double-Blind Placebo-Controlled Study

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

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