Abstract | OBJECTIVE: METHOD: Studies were randomized 8-week, double-blind, placebo-controlled trials evaluating 100- and 250-mg twice daily doses of SSR149415, placebo, and escitalopram 10 mg/day or paroxetine 20 mg/day, conducted from August 2006 through February 2008. Participants met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for MDD or GAD. Baseline Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Depression Rating Scale (HDRS) total scores were ≥ 24 and 18, respectively, and in the GAD trial baseline Hamilton Anxiety Rating Scale (HARS) score was ≥ 22. Primary efficacy variables included changes from baseline in total score on HDRS or HARS and MADRS, and the secondary variable included changes in the Clinical Global Impressions-Severity of Illness score (CGI-S). A 4-week, double-blind, placebo-controlled study evaluating the effect of 100- and 250-mg twice daily doses of SSR149415 on the hypothalamic-pituitary-adrenal (HPA) axis in MDD patients was also conducted. RESULTS: In the GAD trial, SSR149415 did not separate from placebo on the primary (HARS-100 mg: P = .29; 250 mg: P = .21) and secondary (CGI-S-100 mg: P = .18; 250 mg: P = .24) outcome measures, while paroxetine demonstrated efficacy (HARS: P = .003; CGI-S: P = .01). In 2 MDD trials, SSR149415-treated patients did not show significant improvement from baseline on any outcome measure compared with placebo-treated patients (HDRS-100 mg: P = .21 and .48, respectively; 250 mg: P = .22 and P = .46, respectively; CGI-S-100 mg: P = .64 and P = .82, respectively; 250 mg: P = .33 and P = .08, respectively). In the third MDD study, SSR149415 250 mg (P = .04), but not escitalopram (P = .15), demonstrated significant improvement compared to placebo on the HDRS total score at week 8. SSR149415 had no deleterious effects on the HPA axis. CONCLUSIONS: These studies demonstrate that SSR149415 may not be useful for the treatment of GAD and that its antidepressant potential needs to be further evaluated. TRIAL REGISTRATION: ClinicalTrials.gov identifiers: NCT00374166 (Sanofi ID number: DFI5880), NCT00361491 (Sanofi ID number: DFI5879), NCT00358631 (Sanofi ID number: DFI5878), NCT01606384 (Sanofi ID number: PDY5467).
|
Authors | Guy Griebel, Sandra Beeské, Stephen M Stahl |
Journal | The Journal of clinical psychiatry
(J Clin Psychiatry)
Vol. 73
Issue 11
Pg. 1403-11
(Nov 2012)
ISSN: 1555-2101 [Electronic] United States |
PMID | 23146246
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
|
Copyright | © Copyright 2012 Physicians Postgraduate Press, Inc. |
Chemical References |
- 1-(5-chloro-1-((2,4-dimethoxyphenyl)sulfonyl)-3-(2-methoxyphenyl)-2-oxo-2,3-dihydro-1H-indol-3-yl)-4-hydroxy-N,N-dimethyl-2-pyrrolidinecarboxamide
- Anti-Anxiety Agents
- Antidepressive Agents
- Antidiuretic Hormone Receptor Antagonists
- Indoles
- Pyrrolidines
- Citalopram
- Paroxetine
|
Topics |
- Adolescent
- Adult
- Anti-Anxiety Agents
(adverse effects, therapeutic use)
- Antidepressive Agents
(adverse effects, therapeutic use)
- Antidiuretic Hormone Receptor Antagonists
- Anxiety Disorders
(drug therapy)
- Citalopram
(adverse effects, therapeutic use)
- Clinical Trials, Phase II as Topic
- Depressive Disorder, Major
(drug therapy)
- Double-Blind Method
- Female
- Humans
- Indoles
(adverse effects, therapeutic use)
- Male
- Middle Aged
- Multicenter Studies as Topic
- Paroxetine
(adverse effects, therapeutic use)
- Pyrrolidines
(adverse effects, therapeutic use)
- Randomized Controlled Trials as Topic
- Recurrence
- Treatment Outcome
- Young Adult
|