Sertraline Does Not Reduce Depressive Symptoms by Week 6

For patients with depression, sertraline does not reduce depressive symptoms at six weeks, but it does improve anxiety, mental health-related quality-of-life, and self-reported mental health, according to a study published online Sept. 19 in The Lancet Psychiatry.

Gemma Lewis, Ph.D., from University College London, and colleagues examined the clinical effectiveness of sertraline in primary care patients with depressive symptoms of varying severity. A total of 655 patients were randomly assigned to sertraline (326 patients) or placebo (329 patients). The primary outcome analyzed was depressive symptoms measured six weeks after random assignment by the nine-item Patient Health Questionnaire (PHQ-9).

The researchers observed no evidence that sertraline led to a clinically meaningful reduction in depressive symptoms at six weeks, with mean six-week PHQ-9 scores of 7.98 and 8.76 in the sertraline and placebo groups, respectively (adjusted proportional difference, 0.95; 95 percent confidence interval, 0.85 to 1.07; P = 0.41). For secondary outcomes, sertraline led to reduced anxiety symptoms, better mental health-related quality-of-life, and self-reported improvement in mental health (but not physical). The investigators observed weak evidence for a reduction in depressive symptoms with sertraline at week 12.

"Our finding that sertraline affects anxiety more quickly than depressive symptoms has potential implications for understanding the mechanisms of antidepressant treatment," the authors write. "Depressive symptoms could take longer to reduce than anxiety symptoms and some of the reduction might be explained by the earlier effects on anxiety."

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