Papakostas GI, Fava M, Freeman MP, et al. - Researchers conducted a post hoc analysis of CLARITY (a double-blind, randomized, placebo-controlled study in patients with major depression and an insufficient response to prior therapy) to determine the effect of pimavanserin on anxious depression. Randomization of patients in a 3:1 ratio to placebo or pimavanserin 34 mg daily added to ongoing antidepressant therapy was conducted. At 5 weeks, rerandomization of placebo nonresponders was done to placebo or pimavanserin for an additional 5 weeks. Mean change from baseline to week 5 for the Hamilton depression rating scale (HAMD) anxiety/somatization (AS) factor was examined for all patients and those with a score ≥7 at baseline. They observed response rates (≥ 50% reduction in HAMD-17 from baseline) with placebo and pimavanserin of 22.4% and 55.2% and remission rates (HAMD-17 total score < 7) of 5.3% and 24.1%, respectively, among patients with a baseline AS factor score ≥ 7. Findings suggest correlation of adjunctive pimavanserin with a significant improvement among patients with anxious major depressive disorder at baseline.