Selective Serotonin Reuptake Inhibitor Treatment for Generalized Anxiety Disorder: A Double-Blind, Prospective Comparison Between Paroxetine and Sertraline

Objective: Selective serotonin reuptake inhibitors (SSRIs) appear to be an effective class of medications for the treatment of generalized anxiety disorder. Within the SSRI class, however, there have been no comparative treatment studies for this disorder. Therefore, in the present study, we compared the efficacy and tolerability of 2 SSRIs, paroxetine and sertraline, in the treatment of generalized anxiety disorder.

Method: In this parallel-group, double-blind, flexible-dose study, 55 patients with primary generalized anxiety disorder (DSM-IV criteria) were randomly assigned to receive either paroxetine or sertraline treatment for 8 weeks. Primary efficacy measures were the mean changes in Hamilton Rating Scale for Anxiety (HAM-A) scores as well as responder and remission rates based on the Clinical Global Impressions scale. Secondary efficacy measures consisted of the Indiana University Generalized Anxiety Measurement Scale and self-report ratings of anxiety, and quality-of-life outcome. Tolerability was assessed using the Systematic Assessment for Treatment Emergent Events questionnaire for treatment-emergent symptoms.

Results: The intent-to-treat sample consisted of 53 patients who received medication for at least 1 week. Of the 53 patients, 43 completed the entire 8 weeks of treatment. Both paroxetine and sertraline resulted in significant decreases in mean HAM-A scores (paroxetine = 57% ± 28%; sertraline = 56% ± 28%). There were no differences between medication groups on response or remission rates, and tolerability was comparable.

Conclusions: Both paroxetine and sertraline appear similarly effective and well tolerated for the treatment of generalized anxiety disorder.