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Patients with Non-melancholic Depression Might Respond Better to Sertraline than Imipramine
A DGReview of :"Sertraline is more effective than imipramine in the treatment of non-melancholic depression: Results from a multicentre, randomized study"
Progress in Neuro-Psychopharmacology & Biological Psychiatry
04/17/2003
By Veronica Rose
Sertraline appears to be more effective than imipramine for treating the symptoms of acute depression and anxiety in patients with non-melancholic depression, according to Spanish researchers.
They undertook an open-label, parallel group study at Hospital Puerta de Hierro in Madrid to compare efficacy, tolerability and effect on the health-related quality of life between sertraline and imipramine for the management of non-melancholic depression.
A total of 116 patients were randomised to receive sertraline 50-200 mg/day and 123 were given imipramine 75-225 mg/day for 8 weeks.
The intent-to-treat, last-observation-carried-forward analysis showed that sertraline produced significantly greater improvements in depressive symptoms and anxiety symptoms. Scores on the 21-item Hamilton Depression Rating Scale were reduced from 24.9 and 24.4 to 10.3 and 13.1 at end point, respectively (P<.005). Scores on the Hamilton Anxiety Rating Scale were reduced from 21.8 and 21.9 to 9.5 and 13.9, respectively (P<.01).
Response and remission rates also improved significantly at end point with sertraline by comparison with imipramine (69.0% versus 53.7% and 51.3% versus 38.0%; P=.016 and P=.041, respectively) from the fourth week onwards.
Using the Clinical Global Impressions Scale of Improvement, more patients who received sertraline were considered to be very much improved or much improved compared to those treated with imipramine (76.1% vs. 62.8 %, P=.028).
By Week 8, patients in both groups displayed clear quality of life improvements, but the difference between groups was not statistical significant. However, sertraline was significantly better tolerated and fewer patients discontinued therapy due to adverse events compared to imipramine (10.3% vs. 24.4%, P=.004).
Prog Neuropsycholpharmacol Bio Psychiatry 2003;27:3:493-500.
"Sertraline is more effective than imipramine in the treatment of non-melancholic depression: Results from a multicentre, randomized study"
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