Anxiety symptoms are commonly associated with depression, and contribute to a poorer patient prognosis. An increase in serotonergic function is implicated in the pathogenesis of anxiety and there is good evidence that the selective
serotonin re-uptake inhibitors (
SSRIs) may be useful in clinical management.
Sertraline, a novel SSRI, has been shown to be effective in the treatment of anxiety symptoms in both pure and mixed
anxiety disorders. Studies have also shown
sertraline to be effective in
obsessive-compulsive disorder. A recent study (Moon et al. , 1994) shows
sertraline to have comparative therapeutic efficacy with that of
clomipramine with respect to reduction of anxiety symptoms in depression. However, it also highlights important differences in side-effect profiles, with a high incidence of cardiovascular effects and subsequent dropouts reported in the
clomipramine group. Limited comparative data with other
SSRIs suggest there is no evidence of any aggravation of anxiety symptoms during treatment with
sertraline, as has been reported with
fluoxetine.
Sertraline has been shown to have a normalising effect on sleep disturbance in depression without evidence of daytime sedation. Therefore, given the high prevalence of anxiety symptoms in depression,
sertraline would be a useful therapeutic option in clinical management.