Efficacy of Sertraline in Severe Generalized Social Anxiety Disorder: Results of a Double-Blind, Placebo-Controlled Study

Michael R. Liebowitz, MD; Nicholas A. DeMartinis, MD; Karen Weihs, MD; Peter D. Londborg, MD; Ward T. Smith, MD; Henry Chung, MD; Rana Fayyad, PhD; Cathryn M. Clary, MD

J Clin Psychiatry 2003;64(7):785-792

Article Abstract

Background: Generalized social anxiety disorder is an early onset, highly chronic, frequently disabling disorder with a lifetime prevalence of approximately 13%. The goal of the current study was to evaluate the efficacy and tolerability of sertraline for the treatment of severe generalized social anxiety disorder in adults.

Method: After a 1-week single-blind placebo lead-in period, patients with DSM-IV generalized social phobia were randomly assigned to 12 weeks of double-blind treatment with flexible doses of sertraline (50-200 mg/day) or placebo. Primary efficacy outcomes were the mean change in the Liebowitz Social Anxiety Scale (LSAS) total score and the responder rate for the Clinical Global Impressions-Improvement scale (CGI-I), defined as a CGI-I score <= 2. Data were collected in 2000 and 2001.

Results: 211 patients were randomly assigned to sertraline (intent-to-treat [ITT] sample, 205), and 204 patients, to placebo (ITT sample, 196). At week 12, sertraline produced a significantly greater reduction in LSAS total score compared with placebo (mean last-observation-carried-forward [LOCF] change from baseline: -31.0 vs. -21.7; p = .001) and a greater proportion of responders (CGI-I score <= 2: 55.6% vs. 29% among week 12 completers and 46.8% vs. 25.5% in the ITT-LOCF sample; p < .001 for both comparisons). Sertraline was well tolerated, with 7.6% of patients discontinuing due to adverse events versus 2.9% of placebo-treated patients.