2017, Number 6
Response to serotonergic and noradrenergic antidepressants: a crossover study of fluoxetine and desipramine in patients with first major depression episode
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ABSTRACTBackground: Response rate data from studies with different kinds of antidepressant drugs help in the development of guidelines for the rational prescription of pharmacotherapy. However, there are still few comparative studies with selective reuptake inhibition on serotonin or norepinephrine in the same sample of major depression patients. Methods: First episode major depression (DSM-III-R) outpatients who completed 6 weeks in two double-blind randomized trials with fluoxetine and desipramine were crossed over to treatment with the other drug under open conditions for 6 weeks. Response was considered if patient’s final Hamilton depression scale score decreased 50% or more from baseline. Results: No significant differences were found by drug treatment or sequence of treatment. Ten of the 18 patients (55.5%) were responders to both fluoxetine and desipramine, 3 (16.6%) were resistant to fluoxetine, 3 (16.6%) to desipramine and 2 (11.1%) to both drugs. Discussion: These data suggest that among first major depressive episode outpatients fluoxetine and desipramine are equally effective. In patients who have been non-responders to one of the studied drugs, the other one is strikingly effective; this kind of treatment maneuver should be considered in such patients.
Green AI, Schatzberg AF. Obituary. Joseph J. Schildkraut, 1934-2006. Neuropsychopharmacology. 2007;32:1855-6.
Schildkraut, JJ. The catecholamine hypothesis of affective disorders: a review of supporting evidence. Am J Psychiatry. 1965;122:509-22.
Goldstein DJ, Potter WZ, Ciraulo DA, et al. Biological theories of depression and implications for current and new treatments. En: Ciraulo DA, Shader RI, editores. Pharmacotherapy of depression. 2nd ed. New York: Human Press; 2011. p. 1-32.
Humble M. Noradrenaline and serotonin reuptake inhibition as clinical principle: a review of antidepressant efficacy. Acta Psychiatr Scand. 2000;101(Suppl 402):28-36.
Riddle MA, Scahill L, King RA, et al. Double-blind, crossover trial of fluoxetine and placebo in children and adolescents with obsessive-compulsive disorder. J Am Acad Child Adolsc Psychiatr. 1992;31:1062-9.
Goodman WK, Price LH, Delgado PL, et al. Specificity of serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder. Comparison of fluvoxamine and desipramine. Arch Gen Psychiatry. 1990;47:577-85.
Hollander E, Allen A, Kwon J, et al. Clomipramine vs desipramine crossover trial in body dysmorphic disorder. Selective efficacy of a serotonin reuptake inhibitor in imagined ugliness. Arch Gen Psychiatry. 1999;56:1033-9.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd edition-revisited. Washington, DC: American Psychiatric Press; 1987.
Äberg-Wisted A, Jostell KG, Ross SB, et al. Effects of zimelidine and desipramine on serotinin and noradrenaline uptake mechanism in relation to plasma concentrations and to therapeutic effects during treatment of depression. Psychopharmacology. 1981;74:297-305.
Äberg-Wistedt A. A double blind study of zimelidine, a serotonin uptake inhibitor, and desipramine, a noradrenaline uptake inhibitor, in endogenous depression. I. Clinical finding. Acta Psychiatr Scand. 1982;66:50-65.
Äberg-Wistedt A. Comparison between zimelidine and desipramine in endogenous depression. A cross-over study. Acta Psychiatr Scand. 1982;66:129-38.
Lingjaerde O, Bratfos O, Bratlid T, et al. A double-blind comparison of zimelidine and desipramine in endogenous depression. Acta Psychiatr Scand. 1983;68:22-33.
Nystgröm C, Hällström T. Comparison between a serotonin and a noradrenaline reuptake blocker in the treatment of depressed outpatients. A cross-over study. Acta Psychiatr Scand. 1987;75:377-82.
Äberg A. Controlled crossover study of a 5HT uptake inhibiting and an NA uptake inhibiting antidepressant. Acta Psychiatr Scand. 1981;63(Suppl 190):224-55.
van Praag HM. New evidence of serotonin-deficient depressions. Neuropsychobiology. 1977;3:56-63.
Burns RA, Lock T, Edwards DR, et al. Predictors of response to amine- specific antidepressants. J Affect Disord. 1995;35:97-106.
Potter WZ, Calil HM, Extein I, et al. Specific norepinephrine and serotonin uptake inhibitors in man: a crossover study with pharmacokinetic, biochemical, neuroendocrine and behavioral parameters. Acta Psychiatr Scand Suppl. 1981;290:152-65.
Nyström C, Hällström T. Comparison between a serotonin and a noradrenaline reuptake blocker in the treatment of depressed outpatients. A cross-over study. Acta Psychiatr Scand. 1987;75:377-82.
White K, Wykoff W, Tyness LL, et al. Fluovoxamine in the treatment of tricyclic-resistant depression. J Psychatr Neurosci. 1990;15:156-8.
Szegedi A, Wetzel H, Angersbach D, et al. A double-blind study comparing paroxetine and maprotiline in depressed outpatients. Pharmacopsychiatry. 1997;30 97-105.
Nolen WA, van de Putte JJ, Dijken WA, et al. Treatment strategy in depression. I. Non-tricyclic and selective reuptake inhibitors in resistant depression: a double-blind partial crossover study on the effects of oxaprotiline and fluvoxamine. Acta Psychiatr Scand. 1988;78:668-75.
Emrich H, Berger M, Riemann D, et al. Serotonin reuptake inhibition versus norepinephrine reuptake inhibition: a double-blind differential therapeutic study with fluvoxamine and oxaprotiline in endogenous and neurotic depressives. Pharmacopsychiatrica. 1987;20:60-3.
Thase ME, Rush AJ. Treatment-resistant depression. En: Bloom FE, Kupfer DJ, editors. Psychopharmacology, the fourth generation of progress. New York: Raven Press; 1995. p. 1081-97.
Bowden CL, Schatzberg AF, Rosenbaum A, et al. Fluoxetine and desipramine in major depressive disorder. J Clin Psychopharmacol. 1993; 135:305‑11.
Delgado PL, Price LH, Charney DS, et al. Efficacy of fluovoxamine in treatment-refractory depression. J Affect Disord. 1988;15 55-60.
Souery D, Serretti A, Calati R, et al. Citalopram versus desipramine in treatment resistant depression: effect of continuation or switching strategies. A randomized open study. World J Biol Psych. 2011;12 364-73.
Papakostas GI, Fava M. Pharmacotherapy for depression and treatment-resistant depression. USA: World Scientific Publishing Co. Pte. Ltd; 2010.
Nierenberg AA, Papakostas GI, Petersen T, et al. Nortriptyline for treatment- resistant depression. J Clin Psychiatry. 2003;64 35-9.
Suckow RF, Roose SP, Cooper TB. Effect of fluoxetine on plasma desipramine and 2-hidroxydesipramine. Biol Psychiatry. 1992;31(2 Suppl): 200-4.
Preskorn SH, Alderman J, Chung M, et al. Pharmacokinetics of desipramine coadministered with sertraline or fluoxetine. J Clin Psychopharmacol. 1994;14(2 Suppl): 90-8.
Van Ameringen M, Mancini C. Adverse effects of switching from fluoxetine to desipramine (letter). Can J Psychiatry. 1992;37(4 Suppl):278.