Preliminary support for gender differences in response to fluoxetine for generalized anxiety disorder

Depress Anxiety. 2006;23(6):373-6. doi: 10.1002/da.20184.


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.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / drug therapy*
  • Anxiety Disorders / epidemiology
  • Comorbidity
  • Depression / diagnosis
  • Depression / drug therapy
  • Depression / epidemiology
  • Dysthymic Disorder / diagnosis
  • Dysthymic Disorder / drug therapy
  • Dysthymic Disorder / epidemiology
  • Female
  • Fluoxetine / therapeutic use*
  • Humans
  • Male
  • Prevalence
  • Prospective Studies
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Sex Factors
  • Surveys and Questionnaires
  • Treatment Outcome


  • Serotonin Uptake Inhibitors
  • Fluoxetine