title: Preliminary support for gender differences in response to fluoxetine for generalized anxiety disorder.
abstract: Women have a higher prevalence of generalized anxiety disorder (GAD) than do men, but few studies have assessed gender differences in response to pharmacotherapy. In this study we examined gender as a correlate of response to 6 weeks of open, prospective fluoxetine treatment in 23 men and 22 women with a primary diagnosis of GAD. There was no difference by gender in age or prevalence of mood and anxiety comorbidity; however, GAD onset occurred at a significantly younger age in women compared with men. Despite a lack of difference in baseline severity measures, women had a significantly poorer response to fluoxetine as measured by both the Hamilton Anxiety Rating Scale (HAM-A) and Clinician Global Impression-Severity Scale (CGI-S). In multivariate analyses, there was a significant interaction between age of onset and gender: men with younger age of onset and women with older age of onset exhibited poorer response on the HAM-A. These data, though limited in sample size and by the post hoc nature of our analyses, offer preliminary support that women with GAD, particularly those with a later age of onset, may have a poorer response to the selective serotonin reuptake inhibitor (SSRI) fluoxetine. Larger placebo-controlled trials are needed to more definitively examine gender and treatment response in anxiety disorders.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA. nsimon@partners.org
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Simon
authors.forename: Alyson K
authors.initials: AK
authors.lastname: Zalta
authors.forename: John J
authors.initials: JJ
authors.lastname: Worthington
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hoge
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Christian
authors.forename: Julie C
authors.initials: JC
authors.lastname: Stevens
authors.forename: Mark H
authors.initials: MH
authors.lastname: Pollack
mesh_terms: D000328:Adult; D017668:Age of Onset; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors