A comparison of duloxetine hydrochloride with fluoxetine hydrochloride in major depressive disorders: a pilot study

Abstract

To compare remission rate, relapse rate and tolerability of duloxetine, a dual reuptake inhibitor of 5-hydroxy serotonin (5-HT) and norepinephrine (NE), versus fluoxetine, a reuptake inhibitor of 5-HT during follow up period of 16 weeks in major depressive disorder (MDD) a open label comparative trial was conducted. Trial was comprising of 60 patients, diagnosed with MDD, were allocated to fluoxetine group (n*-30, 20-60mg od) or duloxetine group (n*-30, 40-60mg od) for 16 weeks. The end points were remission and relapse assessed by Hamilton Rating scale for Depression-24 items (HAMD-24). In results the mean fall in HAMD-24 scores between groups was comparable till 4 weeks. Thereafter, at 8 weeks the mean fall in HAMD-24 score was significantly greater in duloxetine group (p value < 0.05). At 16 weeks the mean fall was highly significant (p value < 0.01) in duloxetine group. Thirty percent patients in duloxetine group achieved remission in comparison to none in fluoxetine group. None of the patient, in any group, reported relapse. Adverse effects were mild to moderate in severity.In conclusion duloxetine has a better pharmacological profile over fluoxetine in terms of efficacy and safety