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Abstract

Grant Number:	5R01MH070547-02
Project Title:	Pharmacotherapy of Latelife Generalized Anxiety Disorder

PI Information:	Name	Email	Title
	LENZE, ERIC J.	lenzee@wustl.edu	ASSISTANT PROFESSOR

Abstract: 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.

Public Health Relevance:
This Public Health Relevance is not available.

Thesaurus Terms:
anxiety disorder, drug screening /evaluation, genetic polymorphism, human old age (65+), human therapy evaluation, mental disorder chemotherapy, neurogenetics, psychological aspect of aging, serotonin inhibitor, serotonin transporter
clinical trial, cognition, depression, functional ability, mental health epidemiology, outcomes research, pharmacogenetics
behavioral /social science research tag, clinical research, human subject, neuropsychological test, patient oriented research

Institution:	UNIVERSITY OF PITTSBURGH AT PITTSBURGH
	OFFICE OF RESEARCH
	PITTSBURGH, PA 15213
Fiscal Year:	2006
Department:	PSYCHIATRY
Project Start:	15-APR-2005
Project End:	31-JAN-2010
ICD:	NATIONAL INSTITUTE OF MENTAL HEALTH
IRG:	ZMH1

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