Insomnia and Quality of Life in Generalized Anxiety Disorder: Impact on Clinical Presentation and Response to Pregabalin and Venlafaxine-XR

Aims:To assess the impact of insomnia on quality of life (QoL) and functioning in patients with generalized anxiety disorder (GAD), and evaluate the efficacy of pregabalin and venlafaxine-XR in improving sleep and QoL.Methods:A double-blind trial in adults who met DSM-IV criteria for GAD, with a HAM-A total score ≥20,randomized to 8-weeks of flexible-dose treatment with pregabalin (300-600 mg/d, N=121), venlafaxine-XR (75-225 mg/d, N=125), or placebo (N=128).Results:At baseline, 64% of all subjects had insomnia (according to the Medical Outcomes Study Sleep scale [MOS]-Sleep Problems Index [SPI] criteria).While HAM-A total scores (minus the insomnia item) were similar for patients with and without baseline insomnia (25.7 vs. 25.0) those with reported significantly more impairment on the Quality of Life, Enjoyment, and Satisfaction Questionnaire (Q-LES-Q; 45.4 vs. 53.6; p< 0.0001) and Sheehan Disability Scale (SDS; 17.5 vs.14.3; p< 0.0001) than those without. At endpoint, there was a significantly greater mean improvement in MOS-sleep disturbance factor and MOS-SPI with pregabalin (-29.0 and -21.1, respectively) than venlafaxine-XR (-14.7 and -11.0) or placebo (-15.2 and -12.5; all p< 0.05). In more pregabalin (64%) than venlafaxine-XR (51%) or placebo (52%) subjects, abnormal baseline sleep had normalized by endpoint. Endpoint change in MOS-SPI significantly correlated with improvement in both Q-LES-Q and SDS-total scores (Spearman r-values, -0.48 and 0.46, respectively; both p< 0.0001; all subjects).Conclusion:Significantly greater impairment in QoL and functioning was observed in patients with high (vs. low) levels of insomnia. Pregabalin produced significantly greater improvement in insomnia than venlafaxine-XR or placebo.

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The Impact of Medication on Health-Related Quality of Life in Patients with Generalized Anxiety Disorder

CNS Drugs ◽

10.1007/s40263-014-0217-8 ◽

2014 ◽

Vol 29 (1) ◽

pp. 29-40 ◽

Cited By ~ 3

Author(s):

Hilary Wilson ◽

Sally Mannix ◽

Hafiz Oko-osi ◽

Dennis A. Revicki

Keyword(s):

Quality Of Life ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Generalized Anxiety ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact

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Comparison of Sleep Outcomes in Generalized Anxiety Disorder Following Treatment with Pregabalin or Venlafaxine-XR

European Psychiatry ◽

10.1016/s0924-9338(09)70761-8 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1 ◽

Cited By ~ 1

Author(s):

B. Herman ◽

M. Mychaskiw ◽

F. Mandel

Keyword(s):

Anxiety Disorder ◽

Sleep Disturbance ◽

Generalized Anxiety Disorder ◽

Daytime Sleepiness ◽

Sleep Problems ◽

Secondary Analysis ◽

Generalized Anxiety ◽

Medical Outcomes ◽

Double Blind ◽

Insomnia Treatment

Objective:To evaluate the differential effect of pregabalin and venlafaxine-XR versus placebo on sleep outcomes in non-depressed outpatients with generalized anxiety disorder (GAD).Methods:This secondary analysis was based on data from a double-blind trial in which adults who met DSM-IV criteria for GAD were randomized to 8-weeks of flexible-dose treatment with pregabalin (300-600 mg/d; N=121; baseline HAM-A=27.6), venlafaxine-XR (75-225 mg/d: N=125; HAM-A=27.4), or placebo (PBO; N=128; HAM-A=26.8). Sleep was evaluated at baseline, weeks 4, 8, and endpoint using the Medical Outcomes Study (MOS) Sleep Scale, including an overall sleep problems index (SPI), as well as subscale scores such as sleep disturbance.Results:At baseline, 64% of patients with GAD met MOS-Sleep scale criteria for insomnia. Treatment with pregabalin was associated with significant endpoint improvement in the MOS-SPI compared to both placebo (-18.1 vs. -10.5; P< 0.01) and venlafaxine-XR (-10.1: P< 0.01). Treatment with pregabalin was associated with significant endpoint improvement in the MOS-sleep disturbance score compared to both placebo (-22.2 vs. -12.0; P< 0.001) and venlafaxine-XR (-11.6: P< 0.001). While somnolence as a treatment-emergent adverse event occurred more frequently on pregabalin (9.1%) compared to venlafaxine-XR (4.8%) and placebo (2.3%), overall, patients treated with pregabalin reported greater reduction in daytime sleepiness compared to venlafaxine-XR on the MOS-daytime sleepiness sub-scale (-9.7 vs. -5.8).Conclusions:Treatment of moderate-to-severe GAD with pregabalin was associated with significantly better sleep outcomes compared to both placebo and venlafaxine-XR. Improvement in anxiety on pregabalin was associated with reduction in daytime sleepiness.

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Functional and Quality of Life Impairment in Generalized Anxiety Disorder: Effect of Short-term Treatment with Pregabalin and Venlafaxine-XR

European Psychiatry ◽

10.1016/s0924-9338(09)70768-0 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

M.A. Mychaskiw ◽

J.M. Alvir ◽

D.L. Hoffman ◽

B.K. Herman ◽

A. Joshi

Keyword(s):

Quality Of Life ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Change Score ◽

Term Treatment ◽

Similar Proportion ◽

Generalized Anxiety ◽

Short Term Treatment ◽

Double Blind

Aims:To determine the incidence and clinical correlates of functional and quality of life (QoL) impairment in patients with generalized anxiety disorder (GAD), and to evaluate the efficacy of pregabalin and venlafaxine-XR in improving functional outcomes.Methods:A double-blind trial in adults who met DSM-IV criteria for GAD, with a HAM-A total score ≥20, randomized to 8-weeks of flexible-dose treatment with pregabalin (300-600 mg/d, N=121), venlafaxine-XR(75-225 mg/d, N=125), or placebo (N=128). Anxiety-related impairment in QoL was evaluated using the Quality of Life, Enjoyment, and Satisfaction Questionnaire (Q-LES-Q) and impairment in functioning using the Sheehan Disability Scale (SDS).Results:At baseline, a similar proportion of patients in the 3 treatment groups met criteria for impairment on the Q-LES-Q (70.1%-77.6%) and SDS (74.1%-82.7%). For all groups combined, baseline impairment was more highly correlated with psychic than somatic anxiety on both the Q-LES-Q and SDS (Spearman r-values, -0.32 vs. -0.28 and 0.27 vs. 0.14,respectively). On the SDS but not on the Q-LES-Q, significantly more subjects in the pregabalin (67.2%) and venlafaxine-XR (59.5%) groups had improvement into the normative range compared with placebo (42.9%; p< 0.05) at endpoint. The mean HAM-A change score (all subjects) was significantly greater among patients whose Q-LES-Q returned to normal (“remitters” vs. non-remitters: -19.3 vs. -11.9; p< 0.05).Conclusion:At baseline, approximately 75% of GAD patients reported moderate-to-severe impairment in QoL and functioning which was modestly correlated with severity of GAD symptomatology. Pregabalin produced improvement in QoL and functioning that was correlated with reduction in anxiety symptom severity.

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P.2.c.020 The impact of treatment on quality of life in major depressive disorder and generalized anxiety disorder

European Neuropsychopharmacology ◽

10.1016/s0924-977x(07)70512-6 ◽

2007 ◽

Vol 17 ◽

pp. S352

Author(s):

K. Demyttenaere

Keyword(s):

Quality Of Life ◽

Major Depressive Disorder ◽

Anxiety Disorder ◽

Depressive Disorder ◽

Generalized Anxiety Disorder ◽

Generalized Anxiety ◽

Major Depressive ◽

The Impact

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The impact of treatment on quality of life in major depressive disorder (MDD) and generalized anxiety disorder (GAD)

European Psychiatry ◽

10.1016/j.eurpsy.2008.01.323 ◽

2008 ◽

Vol 23 ◽

pp. S201

Author(s):

K. Demyttenaere

Keyword(s):

Quality Of Life ◽

Major Depressive Disorder ◽

Anxiety Disorder ◽

Depressive Disorder ◽

Generalized Anxiety Disorder ◽

Generalized Anxiety ◽

Major Depressive ◽

The Impact

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Effectiveness of Cognitive-Behavioral Therapy (CBT) on Quality of Life (QOL) and Worry in Patients with Generalized Anxiety Disorder (GAD)

International Journal of Indian Psychology ◽

10.25215/0202.021 ◽

2015 ◽

Vol 2 (2) ◽

Author(s):

Sheida Jabalameli ◽

Hamid Taher Neshat Doost ◽

Mohammad Bagher Kajbaf ◽

Hossein Molavi

Keyword(s):

Quality Of Life ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Behavioral Therapy ◽

Control Group ◽

Generalized Anxiety ◽

The Mean ◽

Experimental Group

Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. It has been reported that psychological treatments like Cognitive-Behavioral Therapy (CBT) is effective for patients with GAD. The purpose of the present research was to investigate the effectiveness of CBT on Quality of Life (QOL) and worry in patients with GAD. A sample of 30 patients with GAD who had been referred to psychiatry offices in Isfahan, Iran were selected and assigned into an experimental group (n=15) and a control group (n=15) randomly. The experimental group received CBT in 8 weekly sessions. All participants completed the World Health Organization Quality Of Life-Brief (WHOQOL-BREF) questionnaire and the Penn State Worry Questionnaire (PSWQ) at pretest, posttest and follow up. The results of MANCOVA showed that the mean scores of QOL in the experimental group was significantly higher than the control group at the posttest and follow up (P<0.05) and the mean scores of worry in the experimental group was significantly lower than the control group at the posttest and follow up (P<0.05) It is concluded that CBT can be applied for the patients with GAD as a useful psychological treatment. In general, CBT can improve QOL and decrease worry in patients with GAD.

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