Psychiatr News April 4, 2008
Volume 43, Number 7, page 43
© 2008 American Psychiatric Association
Anxiety in Depression: Findings Questioned
The study "Difference in Treatment Outcome in Outpatients With
Anxious Versus Nonanxious Depression: A STAR*D Report" found
that patients with anxious depression do not respond to treatment with
newer-generation antidepressants as well as patients with nonanxious
depression (see Anxiety Symptoms Complicate Depression Treatment). In an
accompanying editorial, however, J. Craig Nelson, M.D., pointed out that
earlier studies have not found such pronounced differences between depressed
patients with anxiety and those without anxious symptoms.
The editorial and the study findings appear in the March American
Journal of Psychiatry.
For instance, in a study by Gary Tollefson, M.D., Ph.D., and colleagues in
the Journal of Clinical Psychiatry in 1994, 19 double-blind,
randomized trials of fluoxetine including 1,183 patients with major depression
were reviewed. Five of the trials were placebo controlled, and 12 compared
fluoxetine and tricyclic antidepressants. Two of the trials compared
tricyclics and placebo with fluoxetine.
Mean response rates for the fluoxetine trials were about the same for
anxious and nonanxious patients, Nelson noted, but remission rates were
slightly higher in anxious patients (38.3 percent compared with 29.5
percent).
Other meta-analyses showed similar response rates between patients with
anxious and nonanxious depression who were treated with bupropion and SSRIs.
Nelson noted that the SSRIs were slightly more effective in anxious patients,
while bupropion was slightly less effective.
Nelson said in his editorial that there are differences between studies for
a number of reasons, including whether patients have depression with comorbid
anxiety disorders or depression with anxious symptoms.
"I suggest that the difference [between the earlier data] and
STAR*D is the high prevalence of comorbid anxiety disorders in
STAR*D, and this may explain the association of anxiety and
response" in the new STAR*D findings, Nelson wrote.
Related Article:
-
Anxiety Symptoms Complicate Depression Treatment
- Eve Bender
Psychiatr News 2008 43: 38-43.
[Full Text]
Get information about faster international access.
Privacy Policy
Copyright © 2008
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
| 
