Abstract
Our objective was to determine if pretreatment anxiety levels were associated with preferential response to bupropion sustained release (n = 122) or sertraline (n = 126) during a 16-week randomized acute phase treatment study. Both agents had comparable antidepressant activity, and comparable anxiolytic effects using the intent-to-treat sample. Baseline anxiety levels were not related to antidepressant efficacy, and they did not differentiate responders to each agent. Time to clinically significant anxiolysis did not differentiate between treatment groups or between responders to each agent. These results contradict the commonly held, but unsubstantiated, belief that in clinically depressed anxious patients, serotonergic antidepressants are especially anxiolytic and that such patients preferentially benefit from the antidepressant or anxiolytic effects of selective serotonin reuptake inhibitors. Thus, the clinical decision to select between these two agents when treating depressed outpatients cannot rest on either levels of pretreatment anxiety or on anticipation of more rapid or more complete anxiolysis.
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Acknowledgements
Supported in part by a contract from Glaxo Wellcome Inc., a contract from the National Institute of Mental Health (Sequenced Treatment Alternatives to Relieve Depression or STAR*D) (N01-MH-90003), the Sarah M. and Charles E. Seay Center for Basic and Applied Research in Psychiatry and Mental Health Connections, a Texas State Legislature and Dallas County Hospital District funded partnership between Dallas County Department of Mental Health Mental Retardation, and the Department of Psychiatry, University of Texas Southwestern Medical Center. The authors thank David Savage for secretarial support, and Kenneth Z. Altshuler, M.D., Stanton Sharp Distinguished Chair, Professor and Chairman, Department of Psychiatry, UT Southwestern Medical Center for administrative support. Six of the authors (TLH, RMJD, CBW, SRB, JAA, AM) are employees of Glaxo Wellcome, Inc., Research Triangle Park, NC.
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Findings presented, in part, at the annual meeting of the American College of Neuropsychopharmacology, Acapulco, Mexico, December 11–16, 1999, the annual meeting of the American Psychiatric Association, Chicago, IL, May 13–18, 2000, and the annual meeting of the New Clinical Drug Evaluation Unit, Boca Raton, FL, May 30-June 2, 2000.
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Rush, A., Trivedi, M., Carmody, T. et al. Response in Relation to Baseline Anxiety Levels in Major Depressive Disorder Treated with Bupropion Sustained Release or Sertraline. Neuropsychopharmacol 25, 131–138 (2001). https://doi.org/10.1016/S0893-133X(00)00249-9
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DOI: https://doi.org/10.1016/S0893-133X(00)00249-9
