Impact of comorbid sleep-disordered breathing on escitalopram treatment in patients newly diagnosed with generalized anxiety disorder: A 12-week prospective observational study.

Terry B J Kuo, Cheryl C H Yang, Tien-Yu Chen, Hsiao-Ching Lai, Yu-Ting Ho, Chieh-Wen Chen, Hsin-An Chang, Li-Ang Li

Journal: Journal of psychiatric research 2024;180():274-280

PMID: 39471716

Full Text on Elsevier Science View on PubMed

Abstract

We aimed to evaluate the presence of sleep-disordered breathing (SDB) in generalized anxiety disorder (GAD) patients and its impacts after 12-week of escitalopram treatment. In this prospective observational study, GAD patients were followed up to determine whether comorbid SDB affects their treatment response. They underwent a home sleep apnea test (HSAT), and oxygen desaturation index ≥5 was considered indicative of SDB. All participants were treated with escitalopram 5 mg in the first 2 weeks and 10 mg in the remaining 10 weeks. They underwent assessments of heart rate variability and completed questionnaires for sleep, mood, attention, and daytime sleepiness on the day of enrollment, and 2 weeks, 4 weeks, and 12 weeks later. A total of 45 GAD participants (mean age, 56.2 years) were included in the study. Of these, 53.3% had comorbid SDB. Participants with GAD and SDB had higher baseline Beck Anxiety Inventory (BAI) and STOP-BANG scores. Both groups of participants with GAD showed overall improvement in anxiety, depression, and insomnia symptoms after 12 weeks of escitalopram treatment. Additionally, there were no statistically significant differences in the changes in BAI, Beck Depression Inventory, and Epworth Sleepiness Scale scores between the two groups at the Week 2, Week 4, and Week 12 assessments compared to baseline. However, the GAD group with comorbid SDB seemed to have a lower tendency for improvement in depressive symptoms than the group with non-comorbid SDB. Compared with the GAD group without comorbid SDB, the GAD group with comorbid SDB exhibited more severe anxiety symptoms at baseline and tended to show less improvement in depressive symptoms after 12 weeks of escitalopram treatment.

Address: Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan.; Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Human Nutrition and Food-Related Behaviour, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland.; Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan.; Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan.; Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.; Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Department of Otorhinolaryngology, Head and Neck Surgery, Sleep Center, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan.; Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Tsoutun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan. Electronic address: [email protected].; Institute of Brain Science, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Sleep Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, 112, Taipei, Taiwan. Electronic address: [email protected].

DOI: 10.1016/j.jpsychires.2024.10.021

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MeSH Terms: Humans, Female, Middle Aged, Male, Anxiety Disorders, Sleep Apnea Syndromes, Prospective Studies, Comorbidity, Escitalopram, Adult, Aged, Selective Serotonin Reuptake Inhibitors, Citalopram, Psychiatric Status Rating Scales, Treatment Outcome