Date of Award

2020

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not sertraline is effective at reducing the symptoms of anxiety in those diagnosed with generalized anxiety disorder (GAD).

STUDY DESIGN: This is a systematic review of three randomized control trials (RCTs) published between 2008 and 2015, all in the English language and published in peer-reviewed journals.

DATA SOURCES: Three randomized control trials that study the effects of sertraline for reduction of anxiety symptoms in patients with GAD, obtained using PubMed, CINAHL Plus and Academic Search Premier.

OUTCOMES MEASURED: The primary outcome measured in each study was patient-reported reduction in anxiety symptoms and improvement of quality of life. These outcomes were measured using several scales, including the Hamilton Rating Scale for Anxiety, the Pediatric Anxiety Rating Scale, the Children’s Global Assessment Scale, The Clinical Global Impression- Improvement Scale, and the Clinical Global Impressions Severity Scale.

RESULTS: Cvjetkovic-Bosnjak et al. found sertraline to be equally effective as pregabalin for the treatment of GAD (Eur Rev Med Pharmacol Sci 2015: 19 (11), 2020-2024). Similarly, Mokhber et al. found sertraline to be equally effective to buspirone in treating GAD (Psychiatry Clin Neurosci: 64: 128-133. doi: 10.1111/j.1440-1819.2009.02055.x). Finally, Walkup et al. found that sertraline and cognitive behavioral therapy either in combination or as monotherapies are effective in treating GAD (NEJM 2008; 359 (26): 2753-2766. doi: 10.1056/NEJMoa0804633).

CONCLUSION: The results of this systematic review show that sertraline is effective in treating the symptoms of anxiety in patients with a diagnosis of generalized anxiety disorder. While the results from these studies were promising, additional research with larger, more diverse populations, standardized measurements of outcomes, increased time frame, and further examination of adverse drug reactions and cost-effectiveness are required to determine the true long-term benefit of sertraline as therapy for GAD.

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