Desvenlafaxine with mindfulness-based cognitive therapy reduces Hamilton anxiety scores compared to escitalopram with mindfulness-based cognitive therapy in treatment-resistant generalized anxiety disorder.
Karthik Sankar, Sandhiya Ramesh, Natarajan Shanmugasundaram, Deepika Anbalagan, Varadharajan Sivaraman, Venkatesan Singaram, Srikanth Jeyabalan
Pharmacology, biochemistry, and behavior March 1, 2025 DOI: 10.1016/j.pbb.2025.173959 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective cohort study Peer reviewed |
|---|---|
| Population | Patients with treatment-resistant generalized anxiety disorder (GAD) |
| Interventions | Escitalopram Desvenlafaxine Mindfulness-based cognitive therapy (MBCT) |
| Dose | Escitalopram 10 mg; Desvenlafaxine 25 mg |
| Duration | 24 weeks |
| Measures | Hamilton Anxiety Rating Scale (HAM-A), Mindful Attention Awareness Scale (MAAS), Medication Adherence Rating Scale (MARS) |
| Topics | Meditation Anxiety |
| Keywords | Cognitive therapy Inclusive treatment Mental health Resilience Well-being |
| Key findings | Desvenlafaxine (25 mg) combined with MBCT produced significantly greater improvements in HAM-A and MAAS scores at week 16 compared to escitalopram (10 mg) combined with MBCT (P < 0.01). Within-group analysis showed significant score reductions at week 12 for group B versus week 16 for group A (P < 0.01). Medication adherence did not differ significantly between groups (P = 0.122). |
Abstract
This study aims to assess the effectiveness of low-dose Escitalopram (10 mg) or low-dose Desvenlafaxine (25 mg) combined with mindfulness-based cognitive therapy (MBCT) in addressing challenges in treating generalized anxiety disorder (GAD), particularly in patients resistant to conventional therapies. A prospective cohort study was conducted with individuals diagnosed with treatment-resistant GAD. group A included patients unresponsive to citalopram, imipramine, paroxetine, and sertraline, who were then treated with low-dose Escitalopram (10 mg) combined with MBCT. group B comprised those unresponsive to venlafaxine and duloxetine, who were treated with Desvenlafaxine (25 mg) alongside MBCT. Participants were monitored over 24 weeks for changes in Hamilton Anxiety Rating Scale (HAM-A) and Mindful Attention Awareness Scale (MAAS) scores, with medication adherence measured using the Medication Adherence Rating Scale (MARS). The primary outcomes focused on the improvement in anxiety symptoms and overall mental well-being. Comparative analysis between the groups showed significant improvement in HAM-A and MAAS scores at week 16 in group B compared to group A (P < 0.01). Within-group analysis also demonstrated a significant reduction in scores at week 12 in group B compared to group A at week 16 (P < 0.01). No significant difference was observed in medication adherence between the two groups (P = 0.122). Patients treated with low-dose Desvenlafaxine combined with MBCT exhibited greater improvements in managing treatment-resistant GAD compared to those treated with low-dose Escitalopram. This approach highlights the potential for more inclusive and effective mental health strategies, contributing to enhanced quality of life and well-being.