Changes in Anxiety Severity and Acceptability of Venlafaxine in Generalized Anxiety Disorder in the United States: Results From a Real-World Study.

Abstract

Background: Anxiety disorders, including the common generalized anxiety disorder (GAD), are among the leading causes of disability globally. Clinical practice guidelines recommend venlafaxine, a serotonin and norepinephrine reuptake inhibitor, as a first-line pharmacological treatment option for GAD.

Methods: This retrospective cohort study utilized longitudinal real-world data from the US-based database, Holmusk NeuroBlu Data, to explore anxiety severity changes following 30-90 days of venlafaxine prescription in adults with GAD. The main outcome was change from baseline (mean and median) in the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) score, as well as clinically meaningful change (a difference of ≥4 points).

Results: Of 756 patients with GAD (78.6% female, 78.4% White, mean [standard deviation] age 38.5 [14.4 years]), 71.8% had a diagnosis of comorbid major depressive disorder (MDD) at baseline and 23.0% had another anxiety/phobic disorder. Median (interquartile range [IQR]) GAD-7 scores decreased significantly (P<0.001) from 14.0 (10.0-18.0) at baseline (-30 to +7 days from first venlafaxine prescription) to 9.0 (5.0-14.0) points at follow-up (30-90 days after first venlafaxine prescription), a median (IQR) change of -3.0 (-8.0-0.0), corresponding to a shift from moderate to mild anxiety severity. Stratified by baseline anxiety severity, symptom improvement was more pronounced among patients with greater baseline severity. Overall, 48.1% of patients had a clinically meaningful decrease of ≥4 points in GAD-7 score, while only 7.5% significantly worsened. Altogether, 63.6% of patients continued venlafaxine for ≥90 days after first venlafaxine prescription.

Conclusion: In this real-world cohort, improved GAD-7 scores were observed to be associated with venlafaxine prescription.