Preliminary support for gender differences in response to fluoxetine for generalized anxiety disorder
Open accessAbstract
Women have a higher prevalence of generalized anxiety disorder (GAD) than do men, but few studies have assessed gender differences in response to pharmacotherapy. In this study we examined gender as a correlate of response to 6 weeks of open, prospective fluoxetine treatment in 23 men and 22 women with a primary diagnosis of GAD. There was no difference by gender in age or prevalence of mood and anxiety comorbidity; however, GAD onset occurred at a significantly younger age in women compared with men. Despite a lack of difference in baseline severity measures, women had a significantly poorer response to fluoxetine as measured by both the Hamilton Anxiety Rating Scale (HAM-A) and Clinician Global Impression-Severity Scale (CGI-S). In multivariate analyses, there was a significant interaction between age of onset and gender: men with younger age of onset and women with older age of onset exhibited poorer response on the HAM-A. These data, though limited in sample size and by the post hoc nature of our analyses, offer preliminary support that women with GAD, particularly those with a later age of onset, may have a poorer response to the selective serotonin reuptake inhibitor (SSRI) fluoxetine. Larger placebo-controlled trials are needed to more definitively examine gender and treatment response in anxiety disorders.
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Females with GAD do not respond as well to selective serotonin re-uptake inhibitor medication treatment compared with males.
“there is evidence that females with GAD do not respond as well to selective serotonin re -uptake inhibitor (SSRIs) medication treatment compared with males (Simon et al ., 2006)”
From Effectiveness and predictors of group cognitive behaviour therapy outcome for generalised anxiety disorder in an out-patient hospital setting (2024) · cites this paper as Simon et al., 2006
The Results report that women with GAD responded less well than men to fluoxetine, an SSRI, and the Discussion calls this preliminary evidence. The claim extends that finding to SSRI treatment generally, whereas the Discussion says its applicability to other medications is unknown and notes that a larger sertraline study found no gender difference. (LLM, conf=0.88)
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Cites
Kessler, R. C. (1994) · Archives of General Psychiatry · doi:10.1001/archpsyc.1994.03950010008002 · Cited by 12,370 · see citing works
The assessment of anxiety states by rating
HAMILTON, M. (1959) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1959.tb00467.x · Cited by 11,455 · see citing works
(1976) · Medical Entomology and Zoology · Cited by 8,899 · see citing works
Psychiatric disorders in America
Robins, L. N. (1991) · Medical Entomology and Zoology · Cited by 1,567 · see citing works
DSM-III-R Generalized Anxiety Disorder in the National Comorbidity Survey
Wittchen, H.-U. (1994) · Archives of General Psychiatry · doi:10.1001/archpsyc.1994.03950050015002 · Cited by 967 · see citing works
Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors
Thase, M. E., Entsuah, A. R., & Rudolph, R. L. (2001) · The British Journal of Psychiatry · doi:10.1192/bjp.178.3.234 · Cited by 801 · see citing works
Gender Differences in Treatment Response to Sertraline Versus Imipramine in Chronic Depression
Kornstein, S. G., Schatzberg, A. F., Thase, M. E., Yonkers, K. A., McCullough, J. P., Keitner, G. I., Gelenberg, A. J., Thomas, S., Harrison, W. M., & Keller, M. B. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.9.1445 · Cited by 712 · see citing works
Ormel, E. A. J. (1995) · PsycEXTRA Dataset · doi:10.1037/e536912011-072 · Cited by 706 · see citing works
Sex Differences in Antidepressant Response in Recent Antidepressant Clinical Trials
Khan, A., Brodhead, A. E., Schwartz, K. A., Kolts, R. L., & Brown, W. A. (2005) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000168879.03169.ce · Cited by 252 · see citing works
Relative antidepressant efficacy of venlafaxine and SSRIs: sex-age interactions
Thase, M. E., Entsuah, R., Cantillon, M., & Kornstein, S. G. (2005) · Journal of Women s Health · doi:10.1089/jwh.2005.14.609 · Cited by 201 · see citing works
Martényi, F., Dossenbach, M. R. K., Mraz, K., & Metcalfe, S. (2001) · European Neuropsychopharmacology · doi:10.1016/s0924-977x(01)00089-x · Cited by 154 · see citing works
Are There Differences Between Women’s and Men’s Antidepressant Responses?
Quitkin, F. M., Stewart, J. W., McGrath, P. J., Taylor, B. P., Tisminetzky, M. S., Petkova, E., Chen, Y., Ma, G., & Klein, D. F. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.11.1848 · Cited by 146 · see citing works
Pollack, M., Simon, N., Zalta, A., Worthington, J. J., Hoge, E., Mick, E., Kinrys, G., & Oppenheimer, J. E. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.07.005 · Cited by 135 · see citing works
Gender differences in response to differing antidepressant drug classes: two negative studies
Parker, G. B., Parker, G. B., Austin, M., Mitchell, P. B., & Brotchie, H. (2003) · Psychological Medicine · doi:10.1017/s0033291703007918 · Cited by 82 · see citing works
Gender-specific differences in depression and treatment response.
Kornstein, S., Sloan, D., & Thase, M. (2015) · Psychopharmacology bulletin · doi:10.64719/pb.6889 · Cited by 75 · see citing works
Thiels, C., Linden, M., Grieger, F., & Leonard, J. P. (2004) · International Clinical Psychopharmacology · doi:10.1097/00004850-200501000-00001 · Cited by 56 · see citing works
Steiner, M. S., Allgulander, C., Ravindran, A. V., Kosar, H., Burt, T., & Austin, C. (2004) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.648 · Cited by 55 · see citing works
Duloxetine for the Treatment of Major Depressive Disorder in Women Ages 40 to 55 Years
Burt, V. K., Wohlreich, M. M., Mallinckrodt, C. H., Detke, M. J., Watkin, J. G., & Stewart, D. E. (2005) · Psychosomatics · doi:10.1176/appi.psy.46.4.345 · Cited by 33 · see citing works
Sertraline Treatment of Panic Disorder
Pollack, M. H., Rapaport, M. H., Clary, C. M., Mardekian, J., & Wolkow, R. (2000) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v61n1206 · Cited by 28 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.03.006 · Cited by 2,519 · see citing works
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090 · see citing works
Evidence-based pharmacological treatment of generalized anxiety disorder
Baldwin, D. S., Waldman, S., & Allgulander, C. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145710001434 · Cited by 174 · see citing works
Pollack, M. H., Kinrys, G., Krystal, A. D., McCall, W. V., Roth, T. G., Schaefer, K., Rubens, R., Roach, J. M., Huang, H., & Krishnan, R. R. (2008) · Archives of General Psychiatry · doi:10.1001/archpsyc.65.5.551 · Cited by 158 · see citing works
Evidence-based pharmacotherapy of Generalized Anxiety Disorder
Baldwin, D. S., & Polkinghorn, C. (2005) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145704004870 · Cited by 126 · see citing works
Guapo, V. G., Graeff, F. G., Zani, A. C. T., Labate, C. M., dos Reis, R. M., & Del‐Ben, C. M. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.02.007 · Cited by 123 · see citing works
Yuan, J., Luo, Y., Yan, J. H., Meng, X., Yu, F., & Li, H. (2009) · Human Brain Mapping · doi:10.1002/hbm.20796 · Cited by 107 · see citing works
Spinelli, S., Chefer, S. I., Carson, R. E., Jagoda, E. M., Lang, L., Heilig, M. A., Barr, C. S., Suomi, S. J., Higley, J. D., & Stein, E. A. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.12.030 · Cited by 77 · see citing works
Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder.
Dubois, O., Salamon, R., Germain, C., Poirier, M., Vaugeois, C., Banwarth, B., Mouaffak, F., Galinowski, A., & Olié, J. (2010) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2009.11.003 · Cited by 69 · see citing works
Contextual conditioning in rats as an animal model for generalized anxiety disorder
Luyten, L., Vansteenwegen, D., van Kuyck, K., Gabriëls, L., & Nuttin, B. (2011) · Cognitive, Affective, & Behavioral Neuroscience · doi:10.3758/s13415-011-0021-6 · Cited by 57 · see citing works
Examining sex and gender differences in anxiety disorders
Christiansen, D. M. (2015) · A Fresh Look at Anxiety Disorders · doi:10.5772/60662 · Cited by 79 · see citing works
Sex differences in the medial prefrontal cortical glutamate system
Knouse, M. C., McGrath, A. G., Deutschmann, A. U., Rich, M. T., Zallar, L. J., Rajadhyaksha, A. M., & Briand, L. A. (2022) · Biology of Sex Differences · doi:10.1186/s13293-022-00468-6 · Cited by 55 · see citing works
Serretti, A., Chiesa, A., Calati, R., Perna, G., Bellodi, L., & Ronchi, D. D. (2008) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e32831db2d7 · Cited by 48 · see citing works
Kozak, K., Smith, P. H., Lowe, D. J. E., Weinberger, A. H., Cooper, Z. D., Rabin, R. A., & George, T. P. (2021) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2021.1946071 · Cited by 38 · see citing works
Pharmacological Treatment of Generalized Anxiety Disorder
Baldwin, D. S., Ajel, K. I., & Garner, M. J. (2009) · Current topics in behavioral neurosciences · doi:10.1007/7854_2009_2 · Cited by 39 · see citing works
Gray, V., & Hughes, R. N. (2014) · Behavioural Brain Research · doi:10.1016/j.bbr.2014.12.023 · Cited by 36 · see citing works
Sarkar, J., Hiegel, C., Ginis, G. E., Hilbun, E., & Uphouse, L. L. (2007) · Brain Research · doi:10.1016/j.brainres.2007.11.033 · Cited by 30 · see citing works
No effect of sex and estrous cycle on the fear potentiated startle response in rats
Zhao, Y., Bijlsma, E. Y., Verdouw, M. P., & Groenink, L. (2018) · Behavioural Brain Research · doi:10.1016/j.bbr.2018.05.022 · Cited by 26 · see citing works
Abdel-Sater, K. A., Abdel-Daiem, W. M., & Bakheet, M. S. (2012) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2012.04.019 · Cited by 18 · see citing works
U-shaped relationship between ageing and risk-taking behaviour in a wild-type rodent
Lafaille, M., & Féron, C. (2014) · Animal Behaviour · doi:10.1016/j.anbehav.2014.08.018 · Cited by 12 · see citing works
Katzman, M. A., Bleau, P., Blier, P., Chokka, P. R., Kjernisted, K. D., & Ameringen, M. V. (2021) · doi:10.32920/14638581 · Cited by 13 · see citing works
Sanchez, A. L., Comer, J. S., Coxe, S. J., Albano, A. M., Piacentini, J. C., Compton, S. N., Ginsburg, G. S., Rynn, M. A., Walkup, J. T., Sakolsky, D. J., et al. (2019) · Child Psychiatry & Human Development · doi:10.1007/s10578-019-00896-3 · Cited by 12 · see citing works
Predictors of Pharmacotherapy Response in Generalized Anxiety Disorder: A Systematic Review
Ferreira-Garcia, R., Mochcovitch, M. D., do Cabo, M. C., Nardi, A. E., & Freire, R. C. R. (2017) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000127 · Cited by 11 · see citing works
Different patterns of puberty effect in neural oscillation to negative stimuli: sex differences
Yuan, J., Ju, E., Yang, J., Chen, X., & Li, H. (2014) · Cognitive Neurodynamics · doi:10.1007/s11571-014-9287-z · Cited by 9 · see citing works
Evidence-based pharmacotherapy of generalized anxiety disorder
Baldwin, D. S., Waldman, S., & Allgulander, C. (2012) · Cambridge University Press eBooks · doi:10.1017/cbo9780511910395.008 · Cited by 8 · see citing works
Khan, A., Durgam, S., Tang, X., Ruth, A., Mathews, M., & Gommoll, C. (2016) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.15m01904 · Cited by 6 · see citing works
Beesdo‐Baum, K., & Hilbert, K. (2015) · Springer eBooks · doi:10.1007/978-3-319-13060-6_1 · Cited by 7 · see citing works
Prevalence and clinical characteristics of remission during treatment in generalized anxiety
Destoop, M., Eede, F. V. D., Ansseau, M., Albert, A., Vanbelle, S., Mignon, A., Slachmuylders, P., & Sabbe, B. (2013) · International Journal of Psychiatry in Clinical Practice · doi:10.3109/13651501.2013.784789 · Cited by 6 · see citing works
Karayağmurlu, A., Öğütlü, H., Esin, İ. S., Dursun, O. B., & Kızıltunç, A. (2018) · Pakistan Journal of Medical Sciences · doi:10.12669/pjms.344.15555 · Cited by 5 · see citing works
Malivoire, B. L., Stewart, K. E., Cameron, D., Rowa, K., & McCabe, R. E. (2024) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465823000632 · Cited by 4 · see citing works
“Furthermore, there is evidence that females with GAD do not respond as well to selective serotonin re – uptake inhibitor (SSRIs) medication treatment compared with males (Simon et al ., 2006), which supports the possibility of sex differences in treatment response.”
Minhas, M., & Lunn, S. E. (2023) · Journal of Cannabis Research · doi:10.1186/s42238-023-00192-x · Cited by 4 · see citing works
Sex-specific behavioral effects of fluoxetine treatment in animal models of depression and anxiety
Kerčmar, J., & Majdič, G. (2014) · Slovenian Veterinary Research · doi:10.26873/svr-24676-2014 · Cited by 4 · see citing works
Singh, S., Avila, J. T., & Gorrell, S. (2024) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20230039 · Cited by 3 · see citing works
Metabolism and Disposition of a γ-Aminobutyric Acid Type A Receptor Partial Agonist in Humans
Shaffer, C. L., Gunduz, M., Vaz, A. D. N., Venkatakrishnan, K., & Burstein, A. H. (2008) · Drug Metabolism and Disposition · doi:10.1124/dmd.107.019760 · Cited by 3 · see citing works
Anxiety and Related Disorders in Men
Grant, J., & Odlaug, B. (2015) · Springer eBooks · doi:10.1007/978-3-319-13060-6_8 · Cited by 1 · see citing works
Katzman, M. A., Bleau, P., Blier, P., Chokka, P. R., Kjernisted, K. D., & Ameringen, M. V. (2021) · doi:10.32920/14638581.v1 · Cited by 1 · see citing works
Anxiety Disorders and OCD in Men
Goodman, R., Löchner, C., & Stein, D. J. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108646765.010
Current awareness in human psychopharmacology
(2007) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.792
Mental health and reproductive health in women
Toffol, E. (2013) · Työväentutkimus Vuosikirja
Affective-related endophenotypes in serotonin transporter over-expressing mice
Dawson, N. (2008) · OpenGrey (Institut de l'Information Scientifique et Technique)
- Authors
- Simon, N. M., Zalta, A. K., Worthington III, J. J., Hoge, E. A., Christian, K. M., Stevens, J. C., & Pollack, M. H.
- Affiliations
- Massachusetts General Hospital (US)
- Corresponding author
- Simon, Naomi M.
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2006
- Volume
- 23
- Issue
- 6
- Pages
- 373-376
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W2076129870
- Cited by
- 40
- References
- 20
- Citations by year
- 2024: 2 · 2023: 1 · 2022: 1 · 2021: 4 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 5 · 2013: 2 · 2012: 2
- FWCI
- 3.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- generalized anxiety disorder, fluoxetine, gender differences, treatment response, selective serotonin reuptake inhibitors, age of onset, anxiety comorbidity
- MeSH terms
- Adult, Anxiety Disorders, Depression, Female, Fluoxetine, Humans, Male, Prospective Studies, Surveys and Questionnaires, Sex Factors, Comorbidity, Prevalence, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Age of Onset, Dysthymic Disorder
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