PMID- 18172020
OWN - NLM
STAT- MEDLINE
DCOM- 20080423
LR  - 20221207
IS  - 0002-953X (Print)
IS  - 0002-953X (Linking)
VI  - 165
IP  - 3
DP  - 2008 Mar
TI  - Difference in treatment outcome in outpatients with anxious versus nonanxious 
      depression: a STAR*D report.
PG  - 342-51
LID - 10.1176/appi.ajp.2007.06111868 [doi]
AB  - OBJECTIVE: About half of outpatients with major depressive disorder also have 
      clinically meaningful levels of anxiety. The authors conducted a secondary data 
      analysis to compare antidepressant treatment outcomes for patients with anxious 
      and nonanxious major depression in Levels 1 and 2 of the STAR*D study. METHOD: A 
      total of 2,876 adult outpatients with major depressive disorder, enrolled from 18 
      primary and 23 psychiatric care sites, received citalopram in Level 1 of STAR*D. 
      In Level 2, a total of 1,292 patients who did not remit with or tolerate 
      citalopram were randomly assigned either to switch to sustained-release bupropion 
      (N=239), sertraline (N=238), or extended-release venlafaxine (N=250) or to 
      continue taking citalopram and receive augmentation with sustained-release 
      bupropion (N=279) or buspirone (N=286). Treatment could last up to 14 weeks in 
      each level. Patients were designated as having anxious depression if their 
      anxiety/somatization factor score from the 17-item Hamilton Depression Rating 
      Scale (HAM-D) was 7 or higher at baseline. Rates of remission and response as 
      well as times to remission and response were compared between patients with 
      anxious depression and those with nonanxious depression. RESULTS: In Level 1 of 
      STAR*D, 53.2% of patients had anxious depression. Remission was significantly 
      less likely and took longer to occur in these patients than in those with 
      nonanxious depression. Ratings of side effect frequency, intensity, and burden, 
      as well as the number of serious adverse events, were significantly greater in 
      the anxious depression group. Similarly, in Level 2, patients with anxious 
      depression fared significantly worse in both the switching and augmentation 
      options. CONCLUSIONS: Anxious depression is associated with poorer acute outcomes 
      than nonanxious depression following antidepressant treatment.
FAU - Fava, Maurizio
AU  - Fava M
AD  - Depression Clinical and Research Program, Massachusetts General Hospital, Boston, 
      MA 02114, USA. mfava@partners.org
FAU - Rush, A John
AU  - Rush AJ
FAU - Alpert, Jonathan E
AU  - Alpert JE
FAU - Balasubramani, G K
AU  - Balasubramani GK
FAU - Wisniewski, Stephen R
AU  - Wisniewski SR
FAU - Carmin, Cheryl N
AU  - Carmin CN
FAU - Biggs, Melanie M
AU  - Biggs MM
FAU - Zisook, Sidney
AU  - Zisook S
FAU - Leuchter, Andrew
AU  - Leuchter A
FAU - Howland, Robert
AU  - Howland R
FAU - Warden, Diane
AU  - Warden D
FAU - Trivedi, Madhukar H
AU  - Trivedi MH
LA  - eng
GR  - R01 MH080015/MH/NIMH NIH HHS/United States
GR  - R01 MH080015-01/MH/NIMH NIH HHS/United States
GR  - N01 MH 90003/MH/NIMH NIH HHS/United States
PT  - Case Reports
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20080102
PL  - United States
TA  - Am J Psychiatry
JT  - The American journal of psychiatry
JID - 0370512
RN  - 0 (Antidepressive Agents)
RN  - 0 (Cyclohexanols)
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Serotonin Uptake Inhibitors)
RN  - 0DHU5B8D6V (Citalopram)
RN  - 7D7RX5A8MO (Venlafaxine Hydrochloride)
SB  - IM
CIN - Am J Psychiatry. 2008 Mar;165(3):297-9. PMID: 18316424
CIN - Curr Psychiatry Rep. 2008 Aug;10(4):295-6. PMID: 18627666
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - *Ambulatory Care
MH  - Antidepressive Agents/therapeutic use
MH  - Anxiety Disorders/diagnosis/*drug therapy/epidemiology
MH  - Citalopram/adverse effects/*therapeutic use
MH  - Comorbidity
MH  - Cyclohexanols/therapeutic use
MH  - Delayed-Action Preparations
MH  - Depressive Disorder, Major/diagnosis/*drug therapy/epidemiology
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Prospective Studies
MH  - Psychiatric Status Rating Scales/statistics & numerical data
MH  - Selective Serotonin Reuptake Inhibitors/adverse effects/*therapeutic use
MH  - Somatoform Disorders/diagnosis/drug therapy/epidemiology
MH  - Treatment Outcome
MH  - Venlafaxine Hydrochloride
EDAT- 2008/01/04 09:00
MHDA- 2008/04/24 09:00
CRDT- 2008/01/04 09:00
PHST- 2008/01/04 09:00 [pubmed]
PHST- 2008/04/24 09:00 [medline]
PHST- 2008/01/04 09:00 [entrez]
AID - appi.ajp.2007.06111868 [pii]
AID - 10.1176/appi.ajp.2007.06111868 [doi]
PST - ppublish
SO  - Am J Psychiatry. 2008 Mar;165(3):342-51. doi: 10.1176/appi.ajp.2007.06111868. 
      Epub 2008 Jan 2.