P0313 - The treatment of depression with somatic pain

Abstract

Background:

One of the partial solved issues in the treatment of depression is somatic pain. Most antidepressants can reduce the intensity of affective symptoms, but somatic pain, if present, is unfortunately, the last which disappears.

Aim:

to estimate the clinical efficacy of SSRI (paroxetine) compared to venlafaxine XR, a dual action antidepressant, in patients with Major Depressive Disorder (MDD) and somatic pain.

Methods:

Clinical open study including 48 patients (28-56 years), both sexes, with MDD (DSM-IV), mean scores MADRS=28 and somatic pains at baseline (at least 1 symptom moderate-severe)

Instruments:

MADRS, Depression Checklist (developed by University of Michigan Depression Center), CGI-Severity, CGI-Improvement, side effects, somatic conditions and relapse (follow-up: 6 month).

Results:

The patients were divided in 2 groups: Group A: paroxetine (40mg/day), 23 patients; Group B: venlafaxine XR (225mg/day), 25 patients. After 8 weeks: responders in Group A=56%, in Group B= 59%; partial responders: Group A=21% and Group B=15%, non-responsive: Group A=12% and Group B=11%. Drop-outs: Group A=11% and Group B= 15%. Somatic symptoms: 36% of the Group A patients and 28% of the Group B presented at least 1 somatic symptom with moderate to severe intensity. The 6 month follow-up period we evaluated the relapses in all groups and the outcome of the somatic symptoms.

Conclusions:

1. 1. In MDD patients both paroxetine and venlafaxine XR demonstrated a good therapeutic effect.

2. 2. The somatic symptoms were less influenced by both antidepressants, till the end of the study.

3. 3. The group B was more responsive to these important aspects.