An open-label pilot study of fluvoxamine for mixed anxiety-depression

The syndrome of mixed anxiety and depression (MAD) has been described and is familiar to both general psychiatrists and nonpsychiatrists. It was included in the DSM-IV appendix as a syndrome proposed for further study. Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) approved for the treatment of obsessive-compulsive disorder, was studied for its effectiveness in treating anxiety and depression simultaneously during an 8-week, open-label trial of patients with MAD. Thirteen patients were included in the final, intent-to-treat, analysis. Fluvoxamine showed moderately strong effectiveness in improving anxiety and depression with a greater effect on the depressive component. Nausea, insomnia, delayed ejaculation, and nervousness were the most common side effects reported, with no serious adverse events occurring. Future double-blind placebo-controlled studies will give more conclusive results.