Double‐blind comparison between a serotonin and a noradrenaline reuptake blocker in the treatment of depressed outpatients

Abstract

Seventy-five outpatients with major depressive disorder (RDC) were randomly referred to treatment with a dominant serotonin (5-HT) uptake inhibiting drug (zimeldine, 100 mg b.i.d.) or a dominant noradrenaline (NA) uptake inhibiting drug, (maprotiline, 75 mg b.i.d.). The total antidepressive effect was similar in the two groups for up to 4 weeks of treatment. Both drugs gave an effect on the depressive syndrome as a whole, with no preference for mood, anxiety, retardation or vital symptoms. Good response to the NA drug correlated to few prior episodes and few years since first episode, whereas the 5-HT drug had its best effect when there were several previous episodes.

Clinical and biochemical aspects of depressive disorders: III. Treatment and controversies

“…It must be noted, however, that CSF levels of 5HIAA were not significantly decreased in this depressed population; also agitation is not identical with anxiety. Nystrom and Hallstrom (1985) did not find a correlation between the clinical effectiveness of zimeldine (a serotonin uptake inhibitor) and pretreatment scores for mood, retardation, vital symptoms, o r anxietylagitatiodtension. However, the patients studied were a heterogeneous group that included individuals with primary or secondary depression (having other mental or physical disorders), retarded or nonretarded depression, and recurrent or nonrecurrent unipolar depression.…”

Monoamine Transporter Gene Polymorphisms and Antidepressant Response in Koreans With Late-Life Depression

“…33,34 "Cross-talk" between the noradrenergic and serotonergic systems may explain why drugs acting selectively on either one or other of these systems are both active at relieving symptoms of depression. 35 The observed association of the 5-HTTLPR polymorphism with the response to both NRIs and SSRIs may signal a more general association of this polymorphism with response to multiple interventions for depression, including drugs of several classes, placebo, sleep deprivation, and light therapy. It was reported in a white population that patients with the long allele (especially ll genotype) of 5-HTTLPR are more responsive to placebo, sleep deprivation, and light therapy as well as more responsive to drug than those with the short allele.…”

Antidepressants and brain monoaminergic systems: a dimensional approach to understanding their behavioural effects in depression and anxiety disorders

“…Although not listed in DSM-IV as a diagnostic criterion for MDD, it has been estimated that as many as 85 % of adults with depression have significant symptoms of anxiety (Gorman, 1996(Gorman, /1997. In this context, it is clear that all existing antidepressants successfully ameliorate anxiety as a component of depression, including those that selectively block NE reuptake (Ferguson et al, 2002;Kleber, 1979;Nelson, 1999;Nystrom and Hallstrom, 1985;Stahl et al, 2002;Szegedi et al, 1997), as well as bupropion (Trivedi et al, 2001) and mirtazapine (Fawcett and Barkin, 1998), which has a prominent noradrenergic component to its complex pharmacology (Frazer, 1997). Later in this review, with respect to the specific behavioural dimensions that may be affected by drugs regulating noradrenergic and serotonergic function, we will discuss how it may be that SSRIs can be effective in both MDD and the various anxiety disorders, whereas selective NRIs seem to improve non-specific symptoms of anxiety, but are less effective against other symptoms, e.g.…”