Literature DB >> 22147631

What are the clinical implications of new onset or worsening anxiety during the first two weeks of SSRI treatment for depression?

Jackie K Gollan1, Maurizio Fava, Benji Kurian, Stephen R Wisniewski, A John Rush, Ella Daly, Sachiko Miyahara, Madhukar H Trivedi.   

Abstract

OBJECTIVE: To evaluate the prevalence of new onset or worsening of anxiety symptoms, as well as their clinical implications, during the first 2 weeks of Selective Serotonin Reuptake Inhibitor (SSRI) pharmacotherapy for depression.
METHOD: Adult outpatients with nonpsychotic major depressive disorder were enrolled in an 8-week acute phase SSRI treatment trial at 15 clinical sites across the United States. Worsening anxiety was defined as a greater than 2-point increase on the Beck Anxiety Inventory (BAI) between baseline and Week 2. New onset of anxiety symptoms was ascribed when the BAI baseline rating was 0 and the Week 2 value was greater or equal to 2 points on the BAI.
RESULTS: Overall, after 2 weeks of treatment, 48.8% (98 of 201 participants) reported improvement in anxiety symptoms, 36.3% (73 of 201) reported minimal symptom change, and 14.9% (30 of 201) reported worsening of anxiety symptoms. No association was found between change in anxiety symptoms within the first 2 weeks and change in depressive symptoms or remission at the end of 8 weeks of treatment. For participants with clinically meaningful anxiety symptoms at baseline, however, worsening of anxiety during the first 2 weeks of treatment was associated with worsening depressive symptoms by 8 weeks (P = .054).
CONCLUSIONS: The trajectory of anxiety symptom change early in SSRI treatment is an important indicator of eventual outcome for outpatients with major depression and baseline anxiety symptoms.
© 2011 Wiley Periodicals, Inc.

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Year:  2011        PMID: 22147631      PMCID: PMC3860362          DOI: 10.1002/da.20917

Source DB:  PubMed          Journal:  Depress Anxiety        ISSN: 1091-4269            Impact factor:   6.505


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