Houck and Stankovic (1997) performed an 8-week open-label trial of fluvoxamine (Luvox) in 15 outpatients diagnosed as having mixed anxiety depression (MAD). Baseline scores on the HAMD indicated moderate degrees of both anxiety and depression prior to treatment. The patients experienced significant improvement in both areas (p < 0.001). Fluvoxamine has also been compared with benzodiazepines in several relevant clinical trials. Laws and colleagues (1990) conducted a 6-week, multi-centre double-blind comparison of fluvoxamine (Luvox) and lorazepam in the treatment of mixed anxiety depression in 112 outpatients treated by general practitioners. Dosage could range up to 300 mg/day of fluvoxamine (Luvox) and 6 mg/day of lorazepam. Six patients in the fluvoxamine (Luvox) group and four treated with lorazepam dropped out of the study because of intolerance. The majority of these dropouts occurred during the first week. The average final daily doses indicated that treatment was adequate; 163 mg/day of fluvoxamine (Luvox) and 2.96 mg/day for lorazepam. The investigators found equal and significant reductions Read more [...]
Depression Symptoms Treatment
Archive for October, 2010
Carrasco and colleagues (1997) treated 36 patients with mixed anxiety-depression (ICD-10) with sertraline (Zoloft) in an open trial. Concomitant benzodiazepines were not allowed during the study. Twenty-seven patients (75%) were rated as marked or moderate responders by the end of the 8-week study period. A meta-analysis compared the efficacy of sertraline (Zoloft) (N = 218), amitriptyline (N = 214), and placebo (N = 214) in two outpatient studies. The results showed similar efficacy of sertraline (Zoloft) and amitriptyline in reducing both depression and anxiety. Amitriptyline was not tolerated as well as sertraline (Zoloft) and had a greater overall incidence of side effects. There was a higher incidence of anxiety and agitation with amitriptyline in the high anxiety subgroup, and a higher incidence of agitation associated with amitriptyline in the low anxiety subgroup. Sertraline has also been compared with newer antidepressants in mixed anxiety depression. Sertraline and nefazodone were studied in 41 patients with anxious depression. All subjects met DSM-III-R criteria for major depression, Read more [...]
Paroxetine (Paxil) has produced some of the most striking data showing superior efficacy on anxiety symptoms within depression compared with other antidepressants. It has been perceived as one of the more “anxiolytic of the SSRIs” and this has been recognized in the granting of specific labelling for both depression and depression and anxiety in some countries, including the UK. More recently the granting of licenses for OCD, panic disorder, social anxiety disorder, generalized anxiety disorder and PTSD are further evidence of this profile of activity. The evidence of the effect of paroxetine (Paxil) on anxiety symptoms within depression comes from several sources including meta-analysis of studies in depression, from a large study in patients with depression and anxiety symptoms, and from investigation of the effect of paroxetine (Paxil) on coexistent symptoms of anxiety in studies of depressed patients. Meta-analyses have been conducted on paroxetine (Paxil) data similar to those reported on fluoxetine (Prozac). Dunbar and Fuell (1992) compared a database of 2963 paroxetine (Paxil)-treated patients Read more [...]
The efficacy of fluoxetine (Prozac) in anxious depression was reported by Montgomery (1989) in an analysis of the pooled data of those patients who entered studies with moderate or severe degrees of agitation. In a small study, Jouvent and colleagues (1989) reported that fluoxetine (Prozac) was more effective in anxious-impulsive patients than in those with a blunted affect. Several large-scale meta-analyses of fluoxetine (Prozac) data have reported findings supporting the efficacy of fluoxetine (Prozac) in anxious depression. Tollefson and co-workers (1998) reported that fluoxetine (Prozac) was significantly (p < 0.05) more effective than placebo in treating both anxious and non-anxious depression (N = 3183). Fluoxetine was also significantly more effective than placebo in reducing the Hamilton Depression and Anxiety (HAMD) scales anxiety/somatization factor score. The efficacy of fluoxetine (Prozac) and tricyclic antidepressants (TCAs) was comparable on all measures and in all groups. Furthermore, fluoxetine-treated patients were less likely to drop out of treatment due to anxiety than those Read more [...]
Most patients suffering from major depression have anxiety symptoms as well as depressive symptoms and these commonly occurring anxiety symptoms are normally regarded as part of the depressive disorder. The presence of anxiety symptoms does not lead necessarily to a separate diagnosis of an anxiety disorder and indeed widely used depression rating scales include a large number of items devoted to anxiety symptoms, which contribute to the assessment of overall severity of the depression. The large epidemiological studies that have been carried out in recent years have drawn attention to the high rates of comorbidity of psychiatric disorders in the general community. Major depression is known to have a high comorbidity with separate anxiety disorders and a problem can arise in attributing certain anxiety symptoms as part of either the depression or the anxiety disorder. The overlap of major depression and an anxiety disorder where both conditions satisfy the full diagnostic criteria is perceived as comorbidity. In this case separate diagnoses may be considered. The overlap of major depression and Read more [...]