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Sertraline And Imipramine Reduce Anxiety In Depressed Patients
A DGReview of :"Effect of concurrent anxiety on response to sertraline and imipramine in patients with chronic depression"
Depression and Anxiety
03/15/2001
By Mark Greener
Both sertraline and imipramine reduce concurrent anxiety in depressed patients.
Anxiety complicates the clinical presentation of many cases of depression and may be associated with a worse outcome over the longer term. However, the clinical correlates of subsyndromic or secondary anxiety as well as the treatment responses of these syndromes are poorly characterised.
Against this background, researchers from the University of Texas Medical Branch at Galveston and a number of other American centres treated 209 patients presenting using imipramine and 426 patients using sertraline. All patients had chronic major or double depression; 36 percent showed high levels of anxiety on the Hamilton Rating Scale for Depression (HAM-D) anxiety/somatization factor with scores of at least 7.
Kaplan-Meier probability estimates suggested that patients with significant anxiety were more likely to respond after 12 week's treatment than patients who did not have significant anxiety symptoms (66.4 and 54.2 percent, respectively). Response rates for sertraline and imipramine did not differ significantly.
Both sertraline and imipramine reduced high levels of anxiety at baseline. For example, 60 and 58 percent of patients, respectively, showed at least a halving in baseline HAM-D anxiety and somatization scores. Only 4.6 and 9.9 percent, respectively, experienced worsening anxiety. Moreover, acute treatment with either drug improved scores on measures of psychosocial functioning and quality of life.
The authors note that high baseline anxiety was not associated with a reduced overall response to antidepressants. However, high baseline anxiety delayed the onset of response in patients with chronic depression.
Depression and Anxiety 2001;13:18-27.
"Effect of concurrent anxiety on response to sertraline and imipramine in patients with chronic depression"
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