title: Response in relation to baseline anxiety levels in major depressive disorder treated with bupropion sustained release or sertraline.
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.
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9086, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Rush
authors.forename: M H
authors.initials: MH
authors.lastname: Trivedi
authors.forename: T J
authors.initials: TJ
authors.lastname: Carmody
authors.forename: R M
authors.initials: RM
authors.lastname: Donahue
authors.forename: T L
authors.initials: TL
authors.lastname: Houser
authors.forename: C
authors.initials: C
authors.lastname: Bolden-Watson
authors.forename: S R
authors.initials: SR
authors.lastname: Batey
authors.forename: J A
authors.initials: JA
authors.lastname: Ascher
authors.forename: A
authors.initials: A
authors.lastname: Metz
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000188:drug therapy* / Q000503:physiopathology; D016642:Bupropion / Q000008:administration & dosage* / Q000009:adverse effects; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D018765:Dopamine Uptake Inhibitors / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D020280:Sertraline / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D016642:Bupropion; D018765:Dopamine Uptake Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline