Insomnia and generalized anxiety disorder (GAD) are highly prevalent conditions with significant associated distress and morbid consequences.
ANXIETY INSOMNIA ICD 10 REGISTRATION
Trial Registration Identifier: NCT00235508 The most common adverse events with cotherapy were unpleasant taste, headache, dry mouth, and somnolence.Ĭonclusions Coadministration of eszopiclone and escitalopram was well tolerated and associated with significantly improved sleep, daytime functioning, anxiety, and mood in patients with insomnia and GAD. Overall adverse event rates were 77.6% with cotherapy and 67.9% with monotherapy.
After eszopiclone discontinuation, there was no evidence of rebound insomnia, and while treatment differences in anxiety measures were maintained, differences in sleep outcomes were not. The HAM-A response (63% vs 49%, respectively, P = .001) and remission (42% vs 36%, respectively, P = .09) rates at week 8 were higher in patients treated with eszopiclone and escitalopram than those treated with placebo and escitalopram, and median time to onset of anxiolytic response was significantly reduced ( P ≤ .05). Clinical Global Impressions (CGI) of Improvement scores were improved with eszopiclone and escitalopram at every point ( P < .02), while CGI of Severity of Illness scores were not significantly different after week 1. Patients taking eszopiclone and escitalopram had greater improvements in total Hamilton Anxiety Scale (HAM-A) scores at each week ( P < .05) and at weeks 4 through 10 with the insomnia item removed. Results Compared with treatment with placebo and escitalopram, treatment with eszopiclone and escitalopram resulted in significantly improved sleep and daytime functioning ( P < .05), with no evidence of tolerance. Main Outcome Measures Sleep, daytime functioning, psychiatric measures, and adverse events. For the last 2 weeks, eszopiclone was replaced with a single-blind placebo. Interventions Patients received 10 mg of escitalopram oxolate for 10 weeks and were randomized to also receive either 3 mg of eszopiclone (n = 294) or placebo (n = 301) nightly for 8 weeks. Patients Adults aged 18 to 64 years meeting DSM-IV-TR criteria for GAD and insomnia. Setting Multicenter outpatient study from July 2005 to April 2006. Objective To determine the efficacy of eszopiclone combined with escitalopram oxalate in treating insomnia comorbid with GAD.ĭesign Double-blind, randomized, placebo-controlled, parallel-group, add-on therapy 10-week study. Shared Decision Making and CommunicationĬontext Insomnia and generalized anxiety disorder (GAD) are prevalent disorders that may coexist.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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