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Titolo:
Predictors of an acute antidepressant response to fluoxetine and sertraline
Autore:
Flament, MF; Lane, RM; Zhu, R; Ying, Z;
Indirizzi:
Hop La Pitie Salpetriere, CNRS, UMR 7593, INSERM, F-75013 Paris, France Hop La Pitie Salpetriere Paris France F-75013 ERM, F-75013 Paris, France Pfizer Inc, New York, NY USA Pfizer Inc New York NY USAPfizer Inc, New York, NY USA Rutgers State Univ, Dept Stat, Piscataway, NJ USA Rutgers State Univ Piscataway NJ USA Univ, Dept Stat, Piscataway, NJ USA
Titolo Testata:
INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY
fascicolo: 5, volume: 14, anno: 1999,
pagine: 259 - 275
SICI:
0268-1315(199909)14:5<259:POAAAR>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
SEROTONIN REUPTAKE INHIBITORS; MAJOR DEPRESSION; DOUBLE-BLIND; CONTINUATION TREATMENT; GENERAL-PRACTICE; RAT-BRAIN; EFFICACY; MULTICENTER; TRIAL; PLACEBO;
Keywords:
covariate adjustment; interaction; melancholia; multiple logistic regression; neurovegetative; psychomotor disturbance; severe depression; two-sample comparison tests;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
71
Recensione:
Indirizzi per estratti:
Indirizzo: Flament, MF Hop La Pitie Salpetriere, CNRS, UMR 7593, INSERM, Pavillon Clerambault,47 Blvd Hop, F-75013 Paris, France Hop La Pitie Salpetriere Pavillon Clerambault,47 Blvd Hop Paris France F-75013
Citazione:
M.F. Flament et al., "Predictors of an acute antidepressant response to fluoxetine and sertraline", INT CLIN PS, 14(5), 1999, pp. 259-275

Abstract

Sertraline and fluoxetine have different pharmacologic and pharmacokineticprofiles which may be of clinical relevance in the determination of response in different subtypes of depression. A randomized, double-blind, 6-week study comparing sertraline (50-100 mg/day) with fluoxetine (20-40 mg/day) in 286 outpatients with major depression, who had demonstrated comparable efficacy and tolerability for the two drugs, was analysed by subgroups of patients at baseline with melancholia, severe depression, single depressive episode, multiple depressive episodes, high anxiety, low anxiety, psychomotorretardation and psychomotor agitation. Multiple logistic regression with regressors including treatment-by-subgroup variables revealed that, within certain subgroups, the efficacy might differ substantially from that of the whole treatment group. However, the only treatment-by-subgroup interaction term that was significant was anxiety (P < 0.05). There was no evidence of interaction in single or recurrent episode subgroups, and these were not included in subsequent analyses. Subsequent two-sample statistical comparisontests of response (i.e. Hamilton Depression Scale reduction greater than or equal to 50%) rates at study endpoint between treatment groups demonstrated that patients with melancholic depression and those with symptoms of psychomotor agitation yielded a significantly greater proportion of responderswith sertraline compared to fluoxetine (P < 0.05). Response rates in sertraline- and fluoxetine-treated patients, respectively, were: overall study 59%, 51%; melancholia 59%, 44%; severe depression 59%, 41%; low anxiety 71%,55%; high anxiety 47%, 48%; psychomotor retardation, 48%, 46%; and psychomotor agitation 62%, 39%. Multiple logistic regression adjusting for possible confounding factors, that included a treatment by anxiety interaction term,also led to similar findings. In particular, the analysis showed that significant differences existed in favour of sertraline in patients with low anxiety in the melancholia and severe depression subgroups (P < 0.05), indicating that these characteristics predicted a superior response to 6 weeks of treatment with sertraline relative to fluoxetine. Sertraline also demonstrated advantages over fluoxetine on parameters such as sleep and weight disturbance in severely depressed patients, and sleep disturbance, weight, cognitive disturbance and retardation in melancholic patients. Int Clin Psychopharmacol 14:259-275 (C) 1999 Lippincott Williams & Wilkins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 01:40:39