EPA-1129 – Efficacy of Different Antidepressants in Long-Term Treatment of Major Depressive Disorder: A Comparative Study

Abstract

Introduction:

Few studies have compared the available antidepressants in terms of effectiveness in long-term treatment of Major Depressive Disorder (MDD) (Furukawa et al., 2007; Hansen et al., 2008).

Objectives:

Long-term prevention of relapses/recurrence should be the main goal of maintenance MDD treatment.

Aims:

Purpose of the present study was to compare the different antidepressants in terms of retention in treatment (no discontinuation for relapses, hospitalizations or side effects).

Methods:

150 outpatients with a MDD diagnosis and treated with antidepressants in mono-therapy have been included. Follow-up period was defined in 24 months and information have been obtained from charts, interviews with patients and their relatives and from the Lombardy regional database. A survival analysis (Kaplan-Meier) was performed, considering recurrences, hospitalizations or discontinuation due to side effects as ’death’ events.

Results:

48.7% out of patients presented a recurrence within the first two years after the beginning of antidepressant treatment. With the exception of Fluoxetine (p=0.09), Amitriptiline (p=0.13), Fluvoxamine (p=0.83), Venlafaxine (p=0.5) and Trazodone (p=0.58), Bupropione appears to be less effective in long-term treatment of MDD compared to other antidepressants. Fluvoxamine appears to be less effective compared to Citalopram (p=0.036), Paroxetine (p=0.037), Clomipramine (p=0.05), Sertraline (p=0.011) and Duloxetine (p=0.024).

Conclusions:

Bupropione and Fluvoxamine would be less effective in long-term treatment of depression. These data should be confirmed by prospective studies with large samples.