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Major Depression: Tianeptine At Least Halves Relapse And Recurrence Rates
A DGReview of :"Efficacy of tianeptine vs placebo in the long-term treatment (16.5 months) of unipolar major recurrent depression"
Human Psychopharmacology: Clinical and Experimental
03/29/2001
By Mark Greener
In unipolar major depression, tianeptine reduces rates of relapse and recurrence by between two- and three-fold compared to placebo, report researchers from Université Claude-Bernard, in Lyon, and other French centres.
They enrolled 268 patients who fulfilled Diagnostic and Statistical Manual Revision III criteria for major depression and who had Hamilton depression rating scale (HDRS) scores of at least 17 out of 21 and at least one episode of depression in the previous five years. Patients received tianeptine for six weeks in an open study.
Of the 185 responders, 111 received tianeptine 37.5 mg daily, while 74 received placebo for 16.5 months. The authors defined relapse as occurring before six months and recurrences as occurring after six months. Patients were considered to have relapsed or experienced a recurrence if they had a HDRS score of at least 15, a clinical global impression score of at least 4 or both, and clinical confirmation by the investigator.
The tianeptine and placebo groups were similar in most respects at baseline. However, the severity of the depressive episode was greater in the tianeptine group.
A smaller proportion of the tianeptine group experienced either relapses or recurrences compared to placebo (16 and 36 percent, respectively). Moreover, the differences between tianeptine and placebo increased with a longer duration of follow-up. Several secondary analyses confirmed tianeptine's superiority. Adverse events related to treatment were rare and mild in both arms of the study.
The authors conclude that their findings support tianeptine's use in the long-term treatment of unipolar major recurrent depression. The rates of relapse and recurrence decreased between two- and three-fold among tianeptine users compared to placebo. However, the treatments were equally well accepted by the two groups.
Human Psychopharmacology 2001;16:S39-S47.
"Efficacy of tianeptine vs placebo in the long-term treatment (16.5 months) of unipolar major recurrent depression"
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