Sex and Age-Related Differences in Neuroticism and Allostatic Load Index in Urban Patients with General Anxiety Disorder Treated with Alprazolam

Abstract

Introduction: Allostatic Load (AL) index proposes indicators for the functioningof the main potentially stress-affected systems. Sex differences instress response and stress-related diseases susceptibility have been describedfor the general population. In this observational study we describe the effectsof sex and age on allostatic load variables, in a cohort of patients with generalanxiety disorders and neuroticism treated with alprazolam during 12 weeks,before and after treatment. Methods: Patients with general (DSM IV) anxietydisorders with >6 in Hamilton scale, Allostatic load (>1 Crimmins and SeemanAL modified criteria) and neuroticism >18 (NEO-FFI inventory), wereincluded. All patients completed psychiatric assessment, allostatic load indexdetermination before (−1 week) and after 12 weeks of treatment with alprazolam(0.25 - 1 mg/t.i.d). Allostatic load parameters comprised cardiovascular,metabolic and inflammatory variables. Univariate analysis (two-wayANOVA), Student?s t-test (related variables) and Pearson correlations weredetermined. Results: Fifty-four patients, 35 females (48.6 ± 11.7 years) and 19males (44.2 ± 12.8 years) with general anxiety disorder were included; 28 patientswith <50 years (60.7% females), and 26 with ≥50 years (69.2% females).Younger patients (<50 years) (two-way ANOVA, p = 0.02) were significantlyassociated with lower allostatic load index after treatment. However, womenshowed higher anxiety levels in both, before (Two-way ANOVA, p = 0.059)and after treatment (two-way ANOVA, p = 0.005), with a significantly betterprofile than men in many individual AL variables, particularly cardiovascular(systolic blood pressure), obesity (body mass index), and lipids (higher HDLlevels). After treatment a higher reduction of fibrinogen levels was found inmen (two-way ANOVA, p = 0.02). Conclusions: In this preliminary analysiswe described sex and age differences in psychiatry aspects and allostatic loadindexes in patients with general anxiety disorders in the short-term treatmentwith alprazolam. These considerations remark the need of pondering sex andage differences during the use of drugs for protracted periods.