Abstract
BackgroundGeneralized anxiety disorder (GAD) is a persistent and common mental disorder that entails significant impairments in role functioning and quality of life. Currently available effective interventions include psychological therapies, self-help approaches, and pharmacological treatments, which do not quite meet clinical needs, and the ideal anxiolytic is still being sought. Shu-gan-qing-re (SGQR) formula, a Chinese patent medicine, has been well received by patients with GAD in Chinese clinical practice for years. The present prospective, double-blind, double-dummy, randomized controlled trial is designed to investigate the efficacy and safety of SGQR formula for GAD.Methods/designA total of 200 eligible participants will be recruited from four hospitals in different parts of China. They will be randomly assigned to either the study group or the control group in a ratio of 1:1. Participants allocated to the study group will receive SGQR formula and buspirone placebo, while buspirone and SGQR placebo will be applied in the control group. Six scheduled visits will be conducted over the course of 8 weeks. Outcome measurements include Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale-17 (HAMD-17), Clinical Global Impression-Improvement Scale (CGI-I), Traditional Chinese Medicine Syndrome Scale for GAD, and pro-inflammatory cytokine tests: interleukin-1 beta (IL-1β), IL-6, and tumor necrosis factor-alpha. Adverse reactions will be evaluated by using the Treatment Emergent Symptom Scale (TESS). Safety outcomes and adverse events will also be recorded.DiscussionThe study will provide scientific and objective assessments for the efficacy and safety of SGQR formula for patients with GAD, hopefully offering clinicians an alternative approach to GAD.Trial registrationChinese Clinical Trial Registry, ID: ChiCTR-IPR-17013058. Registered on October 20, 2017.
Highlights
Generalized anxiety disorder (GAD) is a persistent and common mental disorder that entails significant impairments in role functioning and quality of life
Interventions Participants allocated to the study group will receive SGQR formula and buspirone placebo, while buspirone and SGQR placebo will be applied in the control group
The higher the Hamilton Depression Rating Scale (HAMD)-17 score, the worse the situation. Another secondary outcome focuses on the improvement in overall symptom severity and functioning, measured by using the Clinical Global Impression-Improvement Scale (CGI-I), which consists of a 7-point global rating (1 = very much improved, 4 = no change, and 7 = very much worse) [12]
Summary
Just like many other Chinese patent medicines, SGQR formula has been widely used in China for years, but strong clinical evidence supporting its use is still lacking, limiting its global popularization. A 5-hydroxytryptamine 1A receptor agonist belonging to azapirones, has been approved for the treatment of GAD in adults and has been shown to be effective [17, 18]. A Cochrane review of randomized controlled trials of azapirones in adults with GAD indicated that this class of medications is relatively well tolerated and effective [18, 19]. Abbreviations b.i.d.: Twice a day; CGI-I: Clinical Global Impression-Global Improvement Scale; CRF: Case report form; GAD: Generalized anxiety disorder; HAM-A: Hamilton Anxiety Rating Scale; HAMD: Hamilton Depression Rating Scale; IL: Interleukin; SGQR: Shu-gan-qing-re; TCM: Traditional Chinese medicine; TESS: Treatment Emergent Symptom Scale; t.i.d.: Three times a day
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