Sex differences in clinical presentation and response in panic disorder: pooled data from sertraline treatment studies.
OBJECTIVE
Gender differences in clinical presentation and response to sertraline treatment were examined for patients diagnosed with DSM-III-R panic disorder with or without agoraphobia.


METHODS
Data was pooled from 4 double-blind, placebo-controlled outpatient studies (males, N = 335; females, N = 338). Two were 12-week fixed-dose studies (sertraline 50 mg vs. 100 mg vs. 200 mg) and 2 were 10-week flexible-dose studies (sertraline 50-200 mg). Primary outcome measures consisted of the Clinical Global Impression-Improvement scale (CGI-I) and change in panic attack frequency.


RESULTS
The clinical presentation of panic disorder was similar except that men reported an earlier age of onset, shorter duration of illness, and significantly more frequent history of alcohol and/or substance dependence/abuse. Sertraline was significantly more effective than placebo in both women and men on the 2 primary outcome measures. When between-sex efficacy was compared, women achieved significantly greater improvement than men on panic frequency and CGI-I, but had equivalent improvement on all other measures. There was no significant between-sex difference in study completion rates, or in adverse event profiles.


CONCLUSIONS
There was a modest but consistent trend for women to show superior efficacy at the end of acute sertraline treatment. This gender effect only occasionally achieved significance, and must be confirmed by future treatment research.
Clayton
A H
AH
University of Virginia School of Medicine, Charlottesville, VA 22903, USA. ahc8v@virginia.edu
Stewart
R S
RS
Fayyad
R
R
Clary
C M
CM
D000328:Adult; D000379:Agoraphobia / Q000188:drug therapy / Q000523:psychology; D000704:Analysis of Variance; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000188:drug therapy* / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D020280:Sertraline / Q000494:pharmacology*; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States
D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline