While effects on depressive symptoms took longer, sertraline eased anxiety symptoms and improved self-reported mental health within 6 weeks in primary care patients with symptoms of depression, according to a study published online in The Lancet Psychiatry.
“We have found important evidence that sertraline can lead to clinical benefits for patients in primary care with depressive symptoms,” researchers wrote. “However, these benefits occur mainly through improvements in anxiety symptoms and quality of life rather than reductions in depressive symptoms.”
The pragmatic, double-blind, multicenter study focused on adults with depressive symptoms of any severity or duration, in whom there was clinical uncertainty about the benefit of an antidepressant. Patients were randomized to 12 weeks of treatment with sertraline or placebo.
When researchers compared 6-week outcomes of 266 patients in the sertraline group with outcomes of 284 patients in the placebo group, they found no evidence that the selective serotonin reuptake inhibitor (SSRI) led to a clinically meaningful reduction in symptoms of depression. Yet they did find reduced symptoms of anxiety, improved mental health-related quality of life, and improved self-reported mental health in the sertraline group, according to the study.
At 12 weeks, researchers observed weak evidence that sertraline reduced depressive symptoms compared with placebo.
“Our findings support the prescription of SSRI antidepressants in a wider group of participants than previously thought,” researchers wrote, “including those with mild to moderate symptoms who do not meet diagnostic criteria for depression or generalized anxiety disorder.”
Researchers believe the trial is the largest of its kind without pharmaceutical industry funding.
Lewis G, Duffy L, Ades A, et al. The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomised trial. The Lancet Psychiatry. 2019 September 19;[Epub ahead of print].