Title: Fluoxetine versus amitriptyline in the treatment of major depression
Abstract: Fluoxetine, a serotonin uptake inhibitor, and amitriptyline, a tricyclic antidepressant, were compared in a 5-week, multicenter, double-blind, randomized trial in 136 out-patient men and women, aged 21–70 years, with major depressive disorder. Overall efficacy was comparable with fluoxetine and amitriptyline [Hamilton 21-Item Rating Scale for Depression (HAM-D21), Raskin, Covi, Clinical Global Impressions-Severity and -Improvement, Patient's Global Impressions]. Mean ± standard deviation decreases in HAM-D21 total score were 12.9 ± 9.9 and 11.6 ± 10.3 (p = 0.423), respectively. Response rates (≥ 50% decrease in HAM-D21 total score) for patients treated ≥ 4 weeks were 46.7% and 66.0% (p = 0.039) and remission rates (HAM-D21 total score ≤ 7) were 18.3% and 28.3% (p = 0.209), respectively. Response and remission rates for all patients were comparable with fluoxetine and amitriptyline. Study completions were higher with fluoxetine than amitriptyline (87.7% vs 66.2%; p = 0.003). Discontinuations for adverse events were higher with amitriptyline than fluoxetine (22.5% vs 6.2%; p = 0.007). More treatment-emergent nausea and insomnia were reported with fluoxetine (p ≤ 0.05); more anticholinergic and orthostatic events and weight gain were reported with amitriptyline (p ≤ 0.05). Statistically, but not clinically, significant changes were observed in vital signs. Both fluoxetine and amitriptyline were effective treatments for out-patients with major depressive disorder. Fluoxetine had a more favorable safety profile than amitriptyline.
Publication Year: 1993
Publication Date: 1993-01-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 33
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