DIFFERENTIAL THERAPY IN GENERALIZED ANXIE TY DISORDERS - 30 SINGLE-CASE EXPERIMENTS

In pharmacotherapy of generalized anxiety disorders (GAD) different ps ychopharmacological agents (neuroleptics, diazepines, antidepressants) proved to be effective. However, there is a lack of predictors of the rapeutic response. The present study was designed to address this ques tion in 30 patients with treatment refractory GAD (12 male, 18 female) . Amitriptyline 30 mg/d, flupentixole 1.5 mg/d, clotiazepam 15 mg/d, a nd placebo were administered double-blind and randomly. Each agent was given 4 times for one week. To avoid carry-over effects, all treatmen t weeks were interrupted by one week's wash-out periods. Thus each sin gle-case experiment comprised 31 weeks. Primary efficacy criterion was Hamilton total score at the end of each treatment week. Statistical a nalysis (U-test) showed that in 19 patients one agent was significantl y (p<0.05) superior to the other substances (clotiazepam n=11, flupent ixol n=3, amitriptyline n=5). Placebo was not superior in any of the 3 0 patients. There was no significant difference between the drugs in 1 1 patients. However, metaanalysis showed that in chronic GAD, by means of single-case experiments, differences in efficacy between different drugs can be found (p<0.01). ANOVA showed no drug x time interaction.