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A double-blind comparison of sertraline and fluoxetine in the treatment of major depressive episode in outpatients

Published online by Cambridge University Press:  16 April 2020

D. Sechter ,
S. Troy ,
S. Paternetti  and
P. Boyer
D. Sechter
Affiliation:
Department of Psychiatry and Medical Psychology, CHU Saint-Jacques Besançon, France
S. Troy
Affiliation:
Pfizer France Orsay, France
S. Paternetti
Affiliation:
Inserm
P. Boyer
Affiliation:
CNRS, Hôpital Pitié-Salpêtrière Paris, France
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Summary

Depression is associated with considerable morbidity and mortality. As depressive disorders carry a high risk of relapse, treatment strategies include the use of a 6-month continuation period after resolution of the acute episode. Tolerability is of major importance when determining compliance and outcome during long-term therapy. Due to the superior tolerability profile of the selective serotonin reuptake inhibitors (SSRIs) over the older tricyclic antidepressants (TCAs), the former may be more suitable for extended therapy. Comparative studies have not shown differences between the SSRIs in terms of efficacy, but side-effect profiles may vary. A multicenter, double-blind, comparative study of sertraline and fluoxetine was carried out in outpatients fulfilling DSM-III-R criteria for major depressive disorder. Patients were randomised to receive sertraline (50—150 mg, n = 118) or fluoxetine (20—60 mg, n = 120) for 24 weeks. Assessments for depression (HAM-D, HAD, CGI-I, CGI-S), anxiety (Covi), sleep (Leeds Sleep Evaluation scale) and quality of life (SIP) were made at study entry and at weeks 2, 4, 8, 12, 18 and 24. All adverse events were recorded to allow evaluation of tolerability. In total, 88 patients in the sertraline group completed the study compared with 79 in the fluoxetine group. Side effects were responsible for the premature treatment withdrawal of seven (6%) sertraline patients and 12 (10%) fluoxetine patients. Two-hundred and thirty-four patients were included in an ITT analysis up to last visit (116 sertraline, 118 fluoxetine). At study endpoint, both treatments produced a significant improvement over baseline on all efficacy variables (P < 0.001). Although the magnitude of global changes in depression, anxiety, and quality of life was larger with sertraline than fluoxetine, none of the between-group differences reached statistical significance. However, significant differences in favour of sertraline were observed for individual HAM-D items including item 4 (insomnia onset) (P = 0.04), item 9 (agitation) (P = 0.02), and item 13 (general somatic symptoms) (P = 0.008). In addition, sertraline was associated with significantly superior performance on the Leeds Sleep Evaluation scale and on SIP items relating to sleep and rest, emotional behaviour and ambulation. Both sertraline and fluoxetine were well tolerated with no significant differences between treatments.

Keywords

depressionsertraline6 monthsquality of lifeSickness Impact Profile
Type
Original article
Information
European Psychiatry , Volume 14 , Issue 1 , March 1999 , pp. 41 - 48
Copyright
Copyright © Elsevier, Paris 1999

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References

Aguglia, ECasacchia, MCassano, GBFaravelli, CFerrari, GGiordano, P. Double-blind study of the efficacy and safety of sertraline versus fluoxetine in major depression Int Clin Psychopharmacol 1993; 8 : 197–202.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Practice Guideline for Major Depressive Disorder in Adults Am J Psychiatry 1993; 150 (4) : 1–23.CrossRefGoogle Scholar
Benfield, PHeel, RCLewis, SP. Fluvoxamine: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in depressive illness Drugs 1986; 32 : 481–508.CrossRefGoogle ScholarPubMed
Bennie, EMullin, JMMartindale, JJ. A double-blind, multicenter trial comparing sertraline and fluoxetine in outpatients with major depression J Clin Psychiatry 1995; 56 : 229–237.Google ScholarPubMed
Bisserbe, JCLane, RWiseman, R. Predictors of response to SSRIs in patients with major depression Eur Neuropsychopharmacol 1996; 6 suppl 3 : 122–122.CrossRefGoogle Scholar
Bisserbe, JCBoyer, PSouetre, EHotton, JMTroy, S. A 6-month sertraline fluoxetine comparative study in depressed outpatients: outcome and costs Eur Neuropsychopharmacol 1996; 6 suppl 3 : 142–142.CrossRefGoogle Scholar
Dunbar, GCCohn, JBFabre, LFFeighner, JPFieve, RRMenders, JA comparison of paroxetine, imipramine and placebo in depressed outpatients Br J Psychiatry 1991; 159 : 394–398.CrossRefGoogle Scholar
Johnson, DAW. Depression: treatment compliance in general practice Acta Psychiatr Scand 1981; 63 : 447–453.CrossRefGoogle Scholar
Johnson, D.A.WNon-compliance with antidepressant therapy - an underestimated problem Intern Med 1986; 11 : 14–17.Google Scholar
Latimer, PRRavindran, AVBernatchez, JPFournier, JPGojer, JABarratt, K. A six month comparison of toleration and efficacy of sertraline and fluoxetine treatment of major depressionPresented at XXth Collegium Internationale Neuropsychopharmacologicum, Melbourne, Australia, 23—27 June 1996.CrossRefGoogle Scholar
Linden, RDNewhouse, PKrishnan, KRFarmer, MGoldstein, BLazarus, LW. SSRIs in the depressed elderly: a double-blind comparison of sertraline and fluoxetine in depressed geriatric outpatientsPresented at 148th American Psychiatric Association, Miami, Florida, USA, 20—25 May 1995.Google Scholar
Montgomery, SAKasper, S. Comparison of compliance between serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis Int Clin Psychopharmacol 1995; 9 : 33–40.CrossRefGoogle ScholarPubMed
Montgomery, SA. Progress on long-term management - report of an ICANP consensusPresented at VIIth European College of Neuropsychopharmacology, Jerusalem, Israel, 16—21 October 1994.Google Scholar
Murdoch, DMcTavish, D. Sertraline: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in depression and obsessive-compulsive disorder Drugs 1992; 44 : 604–624.CrossRefGoogle ScholarPubMed
Newhouse, PAKo, GRichter, E. Comparison of sertraline and fluoxetine in depressed geriatric outpatients: plasma levels and efficacyPresented at XXth Collegium Internationale Neuropsychopharmacologicum, Melbourne, Australia, 23—27 June 1996.CrossRefGoogle Scholar
Richelson, E. Treatment of acute depression Psychopharmacology 1993; 16 : 461–478.Google ScholarPubMed
Turner, R. Quality of life: experience with sertraline International Clinical Psychopharmacology 1994; 9 suppl 3 : 27–31.CrossRefGoogle ScholarPubMed
Van Moffaert, MBartholome, FCosyns, PDeNayer, A.RMertens, C.A controlled comparison of sertraline and fluoxetine in acute and continuation treatment of major depression Human Psychopharmacology 1995; 10 (5) : 393–405.CrossRefGoogle Scholar
WHO Mental Health Collaborating Centres. Pharmacotherapy of depressive disorders. A consensus statement. J Affect Disord 1989; 17 : 197– 198.CrossRefGoogle Scholar
Workman, EAShort, DS. Atypical antidepressants versus imipramine in the treatment of major depression: a meta-analysis J Clin Psychiatry 1993; 51 suppl 6 : 72–86.Google Scholar
Zigmond, ASSnaith, RP. Hospital Anxiety and Depression scale Acta Psychiatr Scand 1983; 67 : 361–370.CrossRefGoogle ScholarPubMed
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