APA: Sertraline Beats Fluoxetine for Severe Depression
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APA: Sertraline Beats Fluoxetine for Severe Depression

By Alison Palkhivala

PHILADELPHIA, PA -- MAY 22, 2002 -- Some patients with depression, particularly those with severe major depression, may respond better to sertraline than to fluoxetine, according to a new meta-analysis.

Study results were presented here this week at the annual meeting of the American Psychiatric Association (APA).

The research, led by Alan D. Feiger, MD, director of the Feiger Health Research Center in Wheat Ridge, Colorado, involved pooling data from available studies of similar design and duration that examined the efficacy of two selective serotonin reuptake inhibitors (SSRIs) -- sertraline and fluoxetine -- on symptoms of major depression.

The researchers included in their meta-analysis a total of five double-blind, head-to-head trials of 12 weeks’ duration.

Overall, the depressed patients who completed the trials responded similarly to both sertraline and fluoxetine.

However, in a sub-analysis of the data including only those participants with Hamilton Depression Rating Scale (HAM-D) scores of 26 or more -- a total of 212 patients with severe major depression -- the pooled data revealed that a statistically significant larger number of those treated with sertraline responded to therapy compared to those on fluoxetine (88 percent vs. 71 percent, respectively, p=0.03). Response to therapy was defined as a Clinical Global Impression-Improvement Scale (CGI-1) score of 1 (very much improved) or 2 (much improved).

Using another definition of response to therapy, a 50 percent or greater reduction in HAM-D total score by week 12, there was a non-significant trend towards a higher response rate in patients treated with sertraline compared to fluoxetine (82 percent vs. 69 percent, p=0.054).

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