efficacy of an eight week trial of imipramine and citalopram in patients with mixed anxiety-depressive disorder

objective: mixed anxiety-depressive disorder (madd) is a condition in which patients have both anxiety and depressive symptoms but do not meet the diagnostic criteria for either an anxiety disorder or a mood disorder. the aim of this study was to compare the efficacy of imipramine and citalopram in the treatment of madd. methods: fifty one outpatients aged 18 to 55 who were diagnosed with madd were randomly assigned to receive citalopram or imipramine for 8 weeks. patients were assessed using hamilton depression rating scale (hdrs) and hamilton anxiety rating scale (hars) at baseline, weeks 4 and 8 of the study. the mean differences in hamilton scores from the baseline were used as the main outcome measures of response to treatment. results: thirty six patients completed the study. patients in the citalopramgroup (n=20) received a mean dosage of 22 mg per day during the first 4 weeks and a mean dosage of 33 mg per day during weeks 4 to 8. subjects in the imipramine group (n= 16) received a mean dosage of 77 mg per day during the first 4 weeks and a mean dosage of 89 mg per day during weeks 4 to 8. it was noted that the both treatments were effective on depression andanxiety at the end of the fourth and eighth weeks. however, the mean differences of hdrs and hars scores between citalopram and imipraminegroups were not significantly different at the end of weeks 4 and 8. conclusion: the results of this study suggest that the efficacy of regular doses of citalopram is comparable with lower range of therapeutic doses of imipramine in the treatment of madd. a more comprehensive study is warranted to confirm the results of this study.