Sertraline in the treatment of mixed anxiety and depression disorder

Background: Mixed anxiety and depression disorder (MAD) has been recognized in ICD-10 as a diagnostic group including those anxious and depressed pati ents which do not fit sufficient criteria for any major axis I disorders. M AD is usually treated as a combination of anxiety and depression, although there are data indicating that selective serotonin reuptake inhibitors (SSR Is) might be active on both anxiety and depression. Method: 38 patients dia gnosed of MAD according to ICD-10 criteria were treated with flexible doses of sertraline for 8 weeks. Benzodiazepines were not allowed during the tri al. Efficacy was evaluated with the Clinical Global Impression (CGI) improv ement scale and with Hamilton's depression and anxiety Scales. Personality scales, including the Cloninger's TCI and Eysenck's EPQ, were used to test the predictive value of personality traits in the response to treatment. Re sults: Anxiety was reduced by 55% and depression by 60% in Hamilton scales. At week 8. 29 patients were considered responders (CGI 1 6 2). Two patient s discontinued the trial, only one of them due to adverse events. The mean dose of sertraline was 83.4 mg/day. Conclusion: Sertraline showed an excell ent tolerability in patients with mixed anxiety-depression disorder despite high levels of baseline anxiety. The response level was high and similar t o that reported for patients with major depression. These results warrant f urther controlled trials to assess the efficacy of SSRIs in MAD. (C) 2000 E lsevier Science B.V. All rights reserved.