Double-blind study of the efficacy and safety of sertraline versus fluoxetine in major depression

Aguglia, Eugenio; Casacchia, M; Cassano, Gb; Faravelli, Carlo; Ferrari, G.; Giordano, Philip; Pancheri, P.; Ravizza, L.; Trabucchi, Marco; Bolino, Francesca

doi:10.1097/00004850-199300830-00010

Cited by 95 publications

(42 citation statements)

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“…Patients treated with fluvoxamine showed a progressive improvement in sleep quality throughout the study, whilst those given fluoxetine showed little improvement after the second week. These findings are consistent with clinical experience suggesting that fluvoxamine causes less sleep disturbance and is less activating than fluoxetine (Baldessarini and Marsh, 1990;Rickels and Schweizer, 1990;Freeman, 1991;Aguglia et al, 1993;Lane et al, 1995).…”

Section: Discussionsupporting

confidence: 86%

“…Findings from meta-analyses have suggested there may be differences in efficacy between the SSRIs in certain patient subgroups, such as those with severe depression (Anderson and Tomenson, 1994). There is also evidence that there are differences in their safety profiles, with paroxetine and sertraline being associated with more sexual sideeffects (Nemeroff et al, 1995;Lane, 1997;Waldinger et al, 1998) and fluoxetine being associated with more anxiety and nervousness (Aguglia et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

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Fluvoxamine versus fluoxetine in major depressive episode: a double‐blind randomised comparison

Daléry

Honig

2003

Human Psychopharmacology

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A double-blind, multinational study was conducted to compare the efficacy and safety of fluvoxamine and fluoxetine in outpatients with major depressive episode; 184 patients were randomised to fluvoxamine (100 mg/day) or fluoxetine (20 mg/day) for 6 weeks. Both drugs were effective and there were no statistically significant differences between them in the area under the curve of change from baseline in the Hamilton depression rating scale (HAMD) total score. However, the percentage of HAMD responders (>or= 50% decrease in HAMD total score) at week 2, the clinical global improvement severity of illness score at week 2 and the depression subscale of the irritability, depression and anxiety scale at weeks 1, 2 and 4, all showed significant advantages for fluvoxamine. During the last 2 weeks, fluvoxamine was significantly more effective in improving the HAMD sleep disturbance scale. Both drugs were well tolerated and there were no marked differences in their side effect profiles which were typical of SSRIs. Fluvoxamine and fluoxetine have similar efficacy and safety profiles in the treatment of major depressive episode; the findings of this study indicate that fluvoxamine may have a faster onset of action with respect to resolution of depressive symptoms and result in a better improvement in sleep quality.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Fluvoxamine versus fluoxetine in major depressive episode: a double‐blind randomised comparison

Daléry

Honig

2003

Human Psychopharmacology

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“…A series of randomized, controlled studies have now demonstrated the efficacy of sertraline versus placebo in the treatment of major depression (55,63,171,198) Since 1990, a number of studies have also evaluated the use of sertraline in the treatment of major depression compared with other SSRIs, including fluoxetine (1,15,35,72,164,238) and citalopram (59); the serotonin norepinephrine reuptake inhibitor venlafaxine (153); TCAs, including clomipramine (135), amytriptyline (43,157), imipramine (110), and nortriptyline (69); the 5-HT 2 antagonist nefazodone (65); and the aminoketone antidepressant bupropion (108).…”

Section: Major Depressionmentioning

confidence: 99%

The Selective Serotonin Reuptake Inhibitor Sertraline: Its Profile and Use in Psychiatric Disorders

2001

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The naphthylamine derivative sertraline is a potent and selective inhibitor of serotonin reuptake into presynaptic terminals. Sertraline has a linear pharmacokinetic profile and a half-life of about 26 h. Its major metabolite, desmethylsertraline does not appear to inhibit serotonin reuptake. Sertraline mildly inhibits the CYP2D6 isoform of the cytochrome P450 system but has little effect on CYP1A2, CYP3A3/4, CYP2C9, or CYP2C19. It is, however, highly protein bound and may alter blood levels of other highly protein bound agents. Sertraline is a widely used serotonin reuptake inhibitor that has been shown to have both antidepressant and antianxiety effects. Many clinical trials have demonstrated its efficacy in depression compared with both placebo and other antidepressant drugs. Its efficacy has also been demonstrated in randomized, controlled trials of patients with obsessive-compulsive disorder, panic disorder, social phobia, and premenstrual dysphoric disorder. In short-term, open-label studies it has appeared efficacious and tolerable in children and adolescents and in the elderly, and data are positive for its use in pregnant or lactating women. Typical side effects include gastrointestinal and central nervous system effects as well as treatment-emergent sexual dysfunction; withdrawal reactions may be associated with abrupt discontinuation of the agent. The safety profile of sertraline in overdose is very favorable. Sertraline's efficacy for both mood and anxiety disorders, relatively weak effect on the cytochrome P450 system, and tolerability profile and safety in overdose are factors that contribute to make it a first-line agent for treatment in both primary and tertiary care settings.

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“…In an 8-week multicenter study, depressed patients were treated with a mean daily dose of 72 mg sertraline compared to a mean daily dose of 28 mg fluoxetine [49]. Both treatment groups showed a significant improvement as compared to baseline with regard to HAM-D and LSEQ.…”

Section: Findings In Patientsmentioning

confidence: 99%

Effects of Selective Serotonin Reuptake Inhibitors on Objective and Subjective Sleep Quality

2000

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The purpose of this paper is to review the effects of selective serotonin (5-HT) reuptake inhibitors on objective and subjective sleep and awakening quality measures. Polysomnography (PSG) demonstrated in both healthy volunteers and depressed patients a decrease in sleep efficiency and total sleep time, a lengthening of sleep latency and a deterioration in sleep continuity, including an increase in the number of awakenings and wake time during the total sleep period. Sleep architecture mostly showed an increase in S1 and S2 and a decrease in S3, S4 and REM sleep as well as a lengthening of REM latency. Objective awakening quality, if measured at all by psychometry, generally showed no decrements. Concerning subjective sleep and awakening quality, normals demonstrated either no changes or a tendency towards a deterioration, while in patients some improvement was observed. Reasons for this discrepancy will be discussed. Novel 5-HT reuptake inhibitors with additional modes of action such as 5-HT2 antagonism (e.g. trazodone, nefazodone) are more likely to improve objective and subjective sleep quality, although some shortcomings may be inherent in regard to comorbidity (e.g. sleep-related breathing disorders). Thus, PSG seems to be a necessity for diagnosis and treatment of complex sleep disorders.

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Double-blind study of the efficacy and safety of sertraline versus fluoxetine in major depression

Cited by 95 publications

References 0 publications

Fluvoxamine versus fluoxetine in major depressive episode: a double‐blind randomised comparison

Fluvoxamine versus fluoxetine in major depressive episode: a double‐blind randomised comparison

The Selective Serotonin Reuptake Inhibitor Sertraline: Its Profile and Use in Psychiatric Disorders

Effects of Selective Serotonin Reuptake Inhibitors on Objective and Subjective Sleep Quality

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