Fluoxetine and Desipramine in Major Depressive Disorder

Are there differences between serotonergic, noradrenergic and dual acting antidepressants in the treatment of depressed women?

“…It is suggested that symptoms of loss of interest, anhedonia, and lack of energy or motor retardation improve better on noradrenergic drugs, whereas serotonergic drugs are more likely to improve anxiety and mood (Nelson et al 2005a). There are some papers that do not find significant differences between the effects of serotonergic and noradrenergic antidepressants on individual symptoms of HDRS (DeJonghe et al 1991;Bowden et al 1993). Similarly Nelson et al (2005b) concluded that the pattern of symptom response was very similar for fluoxetine and reboxetine.…”

Respuesta a antidepresivos serotoninérgicos y noradrenérgicos: estudio cruzado con fluoxetina y desipramina en pacientes con un primer episodio depresivo mayor

“…Al sumar los pacientes que respondieron a ambos medicamentos (55%) y aquellos que solo respondieron a uno (22%), la eficacia antidepresiva para la fluoxetina y la desipramina fue del 77.7%. Cabe señalar que esta tasa es superior a la reportada por Bowden, et al 24 en un estudio doble ciego de 6 semanas en el que respondieron a la fluoxetina el 64% y a la desipramina el 68%. Lingjaerde et al 12 y Äberg-Wistedt 10 encontraron una tendencia bimodal de respuesta (todo o nada) al ISRS zimelidina y a la desipramina en estudios cruzados a doble ciego; situación que no encontramos en nuestro estudio y que puede ser explicada por tratarse de una población diferente de pacientes.…”

Selective Serotonin Reuptake Inhibitors

“…One caveat concerning these studies is that some included only active controls and simply found no difference between, for example, an SSRI and a TCA, which does not prove that the SSRI is as efficacious as the TCA but may only reflect the fact that the sample was too small to separate the treatments (Janicak et al 2001). Five double-blind studies have compared various SSRIs with different TCAs in patients with HAM-D scores of 25 or higher (Reimherr et al 1988;Bowden et al 1993;Feighner et al 1993;Pande and Sayler 1993;Kasper et al 1995), three of which included both inpatients and outpatients (Bowden et al 1993;Pande and Sayler 1993;Kasper et al 1995) and two of which were outpatient studies (Reimherr et al 1988;Feighner et al 1993). In the three studies that were placebo-controlled (Reimherr et al 1988;Feighner et al 1993;Kasper et al 1995), the SSRI tested (fluvoxamine, paroxetine, or sertraline) was either found to be superior to both the TCA and placebo or comparable to the TCA and superior to placebo.…”