Efficacy and safety of etifoxine versus alprazolam in generalized anxiety disorders with somatic symptoms: A randomized, double-blind, comparative study.

Etifoxine, a non-benzodiazepine anxiolytic, is useful for managing anxiety symptoms. However, its role in managing somatic symptoms in generalized anxiety disorder (GAD) remains unclear. Hence, we aimed to compare the efficacy and safety of Etifoxine with Alprazolam in adults with GAD with somatic symptoms. This phase 3, randomized, double-blind, double-dummy study included 260 patients aged 18-65 years with GAD with somatic symptoms who received either Etifoxine 50 mg TID or Alprazolam 0.5 mg TID (1:1) for 4 weeks. The primary outcome was the change from baseline to day 28 in the Hamilton Anxiety Rating Scale (HAM-A) total score. Secondary efficacy outcomes included changes from baseline to days 7 and 14 in HAM-A total score, changes from baseline to days 7, 14, and 28 in HAM-A psychic and somatic sub-scores, clinical global impression-severity score, and percentage of patients with clinical and patient global impression-improvement scale responses. Our study results indicated that both Etifoxine and Alprazolam demonstrated significant improvements in mean change in HAM-A total scores at day 28 from baseline [mean (SD): -13.5 (4.21) and -13.4 (4.64), respectively; p < 0.0001 for both]. The adjusted mean difference (95% CI) was -0.18 (-1.08, 0.72), indicating non-inferiority of Etifoxine. Changes in secondary efficacy parameters were also comparable between groups. Treatment-emergent AEs were mild and observed in 10% and 7.7% of patients in the Etifoxine and Alprazolam groups, respectively. Etifoxine was non-inferior to Alprazolam in reducing anxiety symptoms in GAD, was well-tolerated, and can be a promising alternative for anxiety management without drug dependence risk.