Safety and effectiveness of Escitalopram in an 8-week open study in social anxiety disorder patients at Khyber Pakhtunkhwa, Pakistan: A Prospective Cohort Study

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Abstract A prospective cohort study was designed to investigate the safety and effectiveness of escitalopram (10–20 mg) in the treatment of social anxiety disorder (SAD), with a focus on the population of district Nowshera, Khyber Pakhtunkhwa, Pakistan. The study spanned eight weeks and aimed to assess the impact of escitalopram on patients diagnosed with SAD. The Hamilton Anxiety Rating Scale (HARS) was employed by psychiatrists to measure social anxiety scores before and after the administration of escitalopram. The effectiveness of escitalopram in reducing SAD scores was assessed before and after treatment, using the Wilcoxon signed-rank test, with statistical significance set at P < 0.05. A total of 120 adult participants who were already using escitalopram as prescribed by their physician were enrolled in the study to evaluate the effectiveness of escitalopram. Among them, 57 patients aged between 18 and 39 years were identified as being at high risk of developing SAD. According to gender distribution, females accounted for 61.6% of the sample and exhibited a higher compliance rate compared to males. However, eight patients (6.6%) discontinued the treatment prematurely. The most commonly reported mild adverse drug reactions (ADRs) associated with escitalopram were weight gain and dry mouth, which were observed in both genders. Notably, ejaculation disorder was observed as a prominent ADR in males. The effectiveness of escitalopram was assessed using the Wilcoxon signed-rank test, which demonstrated a significant reduction in the mean social anxiety level score from 13.67 to the lowest possible level (p < 0.001), indicating statistical significance. The study findings indicate that the use of escitalopram resulted in significant symptom improvement, specifically a reduction in anxiety levels, among the patients. Furthermore, the study concluded that escitalopram exhibited a high compliance rate and was deemed safe, as it only led to mild ADRs. These positive outcomes support the effectiveness of escitalopram in the mentioned population for the treatment of SAD.