Agomelatine in depressed patients with comorbid anxiety: subgroup-analysis of the VIVALDI-studies

2018 ◽  
Author(s):  
Gerd Laux
Keyword(s):  
Subgroup Analysis ◽  
Comorbid Anxiety ◽  
Depressed Patients

scholarly journals Treatment of bipolar depression with supraphysiologic doses of levothyroxine: a randomized, placebo-controlled study of comorbid anxiety symptoms

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Maximilian Pilhatsch ◽  
Thomas J Stamm ◽  
Petra Stahl ◽  
Ute Lewitzka ◽  
Anne Berghöfer ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Phenotypic Expression ◽  
Anxiety Symptoms ◽  
Controlled Study ◽  
Double Blind ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Depressive Episodes

Abstract Background Symptoms of anxiety co-occur in a variety of disorders including in depressive episodes of bipolar disorder and in patients with thyrotoxicosis. Treatment of refractory bipolar disorder with supraphysiologic doses of levothyroxine (L-T4) has been shown to improve the phenotypic expression of the disorder and is associated with an increase of circulating thyroid hormones. However, it might be associated with somatic and mental adverse effects. Here we report the investigation of the influence of treatment with supraphysiologic doses of L-T4 on symptoms of anxiety in patients with refractory bipolar depression. Methods Post-hoc analysis from a 6-week, multi-center, randomized, double-blind, placebo-controlled study of the effects of supraphysiologic L-T4 treatment on anxiety symptoms in bipolar depression. Anxiety symptoms were measured weekly with the Hamilton anxiety/somatization factor (HASF) score of the Hamilton Depression Rating Scale (HAMD) and the State- and Trait Anxiety Inventory (STAI). Results Treatment of both groups was associated with a significant reduction in anxiety symptoms (p < 0.001) with no statistical difference between groups (LT-4: from 5.9 (SD = 2.0) at baseline to 3.7 (SD = 2.4) at study end; placebo: from 6.1 (SD = 2.4) at baseline to 4.4 (SD = 2.8) at study end; p = 0.717). Severity of anxiety at baseline did not show a statistically significant correlation to the antidepressive effect of treatment with supraphysiologic doses of L-T4 (p = 0.811). Gender did not show an influence on the reduction of anxiety symptoms (females: from 5.6 (SD = 1.7) at baseline to 3.5 (SD = 2.4) at study end; males: from 6.1 (SD = 2.3) at baseline to 4.0 (SD = 2.4) at study end; p = 0.877). Conclusions This study failed to detect a difference in change of anxiety between bipolar depressed patients treated with supraphysiologic doses of L-T4 or placebo. Comorbid anxiety symptoms should not be considered a limitation for the administration of supraphysiologic doses of L-T4 refractory bipolar depressed patients. Trial registration ClinicalTrials, ClinicalTrials.gov identifier: NCT01528839. Registered 2 June 2012—Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT01528839

Recognition and Treatment of Depression With or Without Comorbid Anxiety Disorders

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S1) ◽  
pp. 1-2 ◽  
Author(s):  
Mark Zimmerman ◽  
Iwona Chelminski ◽  
Sidney Zisook ◽  
David L. Ginsberg
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Clinical Significance ◽  
Psychiatric Patients ◽  
Full Range ◽  
Antidepressant Medication ◽  
Epidemiological Studies ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Increased Risk

AbstractAnxiety disorders are common in depressed patients. Several studies of the full range of Diagnostic and Statistical Manual of MentalDisorders-defined anxiety disorders in depressed psychiatric outpatients each found that when diagnoses are based on semi-structured diagnostic interviews >40% of the patients had a comorbid anxiety disorder. The recognition of comorbidity is not simply of academic interest, but it has important clinical significance. Epidemiological studies, such as the National Comorbidity Study, have demonstrated that depressed individuals with a history of anxiety disorders are at increased risk for hospitalization, suicide attempt, and greater impairment from the depression. The co-occurrence of anxiety disorders in depressed patients has been associated with a more chronic course of depression in psychiatric patients, primary care patients, and epidemiological samples. Recent research has suggested that clinicians underrecognize anxiety disorder comorbidity in depressed patients. The clinical significance of this underrecognition is highlighted by the finding that patients often want treatment to address their anxiety disorder comorbidity. When anxiety disorders are detected they often influence clinicians' selection of antidepressant medication, though some of clinicians' prescribing biases are not supported by empirical data.In this monograph, Iwona Chelminski, PhD, reviews the significance of anxiety in patients with depression as well as diagnostic instruments for recognizing this comorbidity. Next, Mark Zimmerman, MD, addresses the factors that affect the clinician's choice of antidepressant, focusing on the influence of comorbid anxiety. Finally, Sidney Zisook, MD, discusses the differential efficacy of antidepressants as well as the role of psychotherapy in patients with comorbid anxiety and depression.

Recognition and Treatment of Depression with or Without Comorbid Anxiety Disorders

CNS Spectrums ◽  
2006 ◽  
Vol 11 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Mark Zimmerman ◽  
Iwona Chelminski ◽  
Sidney Zisook ◽  
David L. Ginsberg
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Clinical Significance ◽  
Psychiatric Patients ◽  
Full Range ◽  
Antidepressant Medication ◽  
Epidemiological Studies ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Increased Risk

ABSTRACTAnxiety disorders are common in depressed patients. Several studies of the full range of Diagnostic and Statistical Manual of Mental Disorders-defined anxiety disorders in depressed psychiatric outpatients each found that when diagnoses are based on semi-structured diagnostic interviews >40% of the patients had a comorbid anxiety disorder. The recognition of comorbidity is not simply of academic interest, but it has important clinical significance. Epidemiological studies, such as the National Comorbidity Study, have demonstrated that depressed individuals with a history of anxiety disorders are at increased risk for hospitalization, suicide attempt, and greater impairment from the depression. The co-occurrence of anxiety disorders in depressed patients has been associated with a more chronic course of depression in psychiatric patients, primary care patients, and epidemiological samples. Recent research has suggested that clinicians underrecognize anxiety disorder comorbidity in depressed patients. The clinical significance of this underrecognition is highlighted by the finding that patients often want treatment to address their anxiety disorder comorbidity. When anxiety disorders are detected they often influence clinicians' selection of antidepressant medication, though some of clinicians' prescribing biases are not supported by empirical data.In this monograph, Iwona Chelminski, PhD, reviews the significance of anxiety in patients with depression as well as diagnostic instruments for recognizing this comorbidity. Next, Mark Zimmerman, MD, addresses the factors that affect the clinician's choice of antidepressant, focusing on the influence of comorbid anxiety. Finally, Sidney Zisook, MD, discusses the differential efficacy of antidepressants as well as the role of psychotherapy in patients with comorbid anxiety and depression.

Delayed response to antidepressants in depressed patients with comorbid anxiety

1995 ◽  
Vol 37 (9) ◽  
pp. 607
Author(s):  
J.M. Russell ◽  
L. Koran ◽  
R.M.A. Hirschfeld ◽  
M.D. McGee
Keyword(s):  
Delayed Response ◽  
Comorbid Anxiety ◽  
Depressed Patients

scholarly journals Identifying Depressed Patients With a High Risk of Comorbid Anxiety in Primary Care

2003 ◽  
Vol 05 (03) ◽  
pp. 104-110 ◽  
Author(s):  
Bradford L. Felker ◽  
Susan C. Hendrick ◽  
Edmunnd F. Chaney ◽  
Chuan-Fen Liu ◽  
Patrick Heagerty ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Comorbid Anxiety ◽  
Depressed Patients

Fluoxetine treatment of depressed patients with comorbid anxiety disorders

2002 ◽  
Vol 16 (3) ◽  
pp. 215-219 ◽  
Author(s):  
Shamsah B. Sonawalla ◽  
Amy Farabaugh ◽  
Mary W. Johnson ◽  
Meridith Morray ◽  
Margarita L. Delgado ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Fluoxetine Treatment
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