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A 12-week study comparing moclobemide and sertraline in the treatment of outpatients with atypical depression

Jernbanevej 9, Postboks 7, 4400 Kalundborg, Denmark

Roger Lane

Pfizer Inc, 235 East 42nd Street, NewYork, NY 10017, USA laner{at}pfizer.com

Paul Latimer

Department of Psychiatry, Kelowna General Hospital, 2268 Pandosy Street, Kelowna, British Columbia V1Y 1T2, Canada

Kirsten Behnke

FalkonerAlle 112, 2000 Fredriksberg, Denmark

Poule E. Christiansen

Rosenkrantzgade 2, 8000 Arhus C

Bjarne Nielsen

HC Andersens Boulevard 51, 3th, 1553 CopenhagenV, Denmark

Arun V. Ravindran

Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4, Canada

Robin T. Reesal

Western Canada Behaviour Research Centre, Alberta Professional Building, Suite 210, 320-23 Avenue SW, Calgary, Alberta T2S 9J2, Canada

Daryl P. Goodwin

Sandgate Road Surgery, Sandgate Road, Folkestone, Kent CT20 2HN, UK

One hundred and ninety-seven outpatients with atypical depression [Atypical Depression Diagnostic Scale (ADDS) score=4] were randomized to 12 weeks of double-blind treatment with sertraline or moclobemide in a multicentre, parallel-group clinical trial. Patients were started on either 50 mg/day sertraline or 300 mg/day moclobemide. If the therapeutic response was not satisfactoryafter 4 weeks, the dose could be increased to either 100 mg/day sertraline or 450 mg/day moclobemide. Primary effcacy evaluations were the 29-item Hamilton Psychiatric Rating Scale for Depression (HAM-D) and the Clinical Global Impression of Improvement (CGI I) response rate (much or very much improved) at study endpoint. Secondary effcacy evaluations included the ADDS, the Hamilton Anxiety Scale (HAMA), the Leeds Sleep Scale, and the Battelle Quality of Life Battery (BQOLB). In the analysis of the 172 patient effcacy-evaluable population, there was significant baseline to endpoint improvement in all primary and secondary effcacy assessments after treatment with either sertraline or moclobemide. At the endpoint, the proportion of responders on CGI-I, was 77.5% in the sertraline group and 67.5% in the moclobemide group (p=0.052). The baseline to endpoint mean 29-item HAM-D score decreased from 35.9 to 14.5 in the sertraline group and from 36.3 to 16.1 in the moclobemide group. Sertraline also resulted in a significantly (p50.05) greater degree of improvement at the endpoint, compared with moclobemide, in the proportion of remitters on the HAMA (total score47), ADDS Category IID (Rejection Sensitivity), Leeds Sleep Factor 4 (Integrity of Behaviour Following Awakening), and on three dimensions of the BQOLB (Energy/Vitality, Social Interaction and Life Satisfaction). There were no other significant differences between treatment groups. Overall, both medications were well tolerated. In this study, both sertraline and moclobemide improved the symptoms of atypical depression.

Key Words: atypical depression • moclobemide • sertraline

Journal of Psychopharmacology, Vol. 13, No. 4, 406-414 (1999)
DOI: 10.1177/026988119901300412


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