Response in relation to baseline anxiety levels in major depressive disorder treated with bupropion sustained release or sertraline

Our objective was to determine if pretreatment anxiety levels were associat ed with preferential response to bupropion sustained release (n = 122) or s ertraline (n = 126) during a 16-week randomized acute phase treatment study . Both agents had comparable antidepressant activity, and comparable anxiol ytic effects using the intent-to-treat sample. Baseline anxiety levels were not related to antidepressant efficacy, and they did not differentiate res ponders to each agent. Time to clinically significant anxiolysis did not di fferentiate between treatment groups or between responders to each agent. T hese results contradict the commonly held, but unsubstantiated, belief that in clinically depressed anxious patients, serotonergic antidepressants are especially anxiolytic and that such patients preferentially benefit from t he antidepressant or anxiolytic effects of selective serotonin reuptake inh ibitors. Thus, the clinical decision to select between these two agents whe n treating depressed outpatients cannot rest on either levels of pretreatme nt anxiety or on anticipation of more rapid or more complete anxiolysis. [N europsychopharmacology 25:131-138, 2001] (C) 2001 American College of Neuro psychopharmacology. Published by Elsevier Science Inc.