Pharmacotherapy of Latelife Generalized Anxiety Disorder

晚年广泛性焦虑症的药物治疗

• 批准号: 6874673
• 负责人: Eric J Lenze
• 金额: $ 24.35万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-15 至 2010-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6874673
• 关键词: anxiety disorders; behavioral /social science research tag; clinical research; clinical trials; cognition; depression; drug screening /evaluation; functional ability; genetic polymorphism; human old age (65+); human subject; human therapy evaluation; mental disorder chemotherapy; mental health epidemiology; neurogenetics; neuropsychological tests; outcomes research; patient oriented research; pharmacogenetics; psychological aspect of aging; serotonin inhibitor; serotonin transporter

DESCRIPTION (provided by applicant): This R01 resubmission from a new principal investigator focuses on generalized anxiety disorder (GAD) in elderly persons, a significant public health issue because of the high prevalence and burden of GAD in this age group. However, the treatment evidence in late life GAD is inadequate, and the illness remains vastly under treated. This study is a 12 week randomized, double-blind, placebo-controlled examination of escitalopram, an SSRI that is well-tolerated and highly specific for the serotonin transporter (SERT). We will recruit 176 subjects aged 60 and older from primary care practices for treatment. Subjects will have GAD without current major depressive disorder. The study will allow inclusion of comorbidity commonly seen in anxious elderly, including depression. We will examine symptomatic response. As secondary, exploratory analyses, we will examine treatment-attributable changes in functional disability and neuropsychological measures. We will genotype subjects in terms of a SERT polymorphism which has been posited as a moderator of SSRI treatment outcome, and we will determine whether allelic variation in the SERT contributes to the variability of treatment response. Our first goal is to demonstrate SSRI efficacy for late life GAD in the primary care sector. It is our expectation that demonstration of medication efficacy in this population (and dissemination of the results) would lead to increased utilization of pharmacotherapy for this disorder. Efficacy evaluation will include examination of functional and neuropsychological improvements from treatment. The second goal is the examination of a genetic moderator of treatment response - such findings could lead not only to improvements in the individualization of treatment for late life GAD, but also to a greater understanding of the neurobiological sources of heterogeneity in this disorder.

描述（由申请人提供）：该R01从新的首席研究人员重新提交了老年人的普遍焦虑症（GAD），这是一个重大的公共卫生问题，因为该年龄段的GAD的高龄和负担很高。但是，晚期GAD中的治疗证据不足，并且疾病仍然受到极大的治疗。这项研究是一项为期12周的随机，双盲的，安慰剂对照的检查，依他普兰（Escitalopram）是一种耐受性良好且对5-羟色胺转运蛋白（SERT）高度特异性的SSRI。我们将从初级保健实践中招募176名60岁及60岁的受试者。受试者将拥有GAD，而没有当前重大抑郁症。这项研究将允许在包括抑郁症在内的焦虑老年人中可能看到的合并症。我们将检查有症状的反应。作为次要的探索性分析，我们将检查功能残疾和神经心理学指标的治疗方法变化。我们将根据SERT多态性的基因型受试者，该受试者被认为是SSRI治疗结果的主持人，我们将确定SERT中的等位基因变异是否有助于治疗反应的可变性。我们的第一个目标是在初级保健领域表现出SSRI疗效的SSRI疗效。我们期望在该人群中（以及结果传播）的药物疗效证明会导致对这种疾病的药物治疗的利用增加。功效评估将包括检查治疗的功能和神经心理学改善。第二个目标是检查治疗反应的遗传主持人 - 这种发现不仅可以改善晚期生命GAD的个性化治疗，而且还可以更了解这种疾病中异质性的神经生物学来源。