Efficacy and Response Time to Sertraline Versus Fluoxetine in the Treatment of Unipolar Major Depressive Disorder
J Clin Psychiatry 2000;61(12):942-946
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Few studies have compared the
treatment efficacy of the 2 selective serotonin reuptake
inhibitors sertraline and fluoxetine.
Method: A randomized, single-blind,
parallel-group study of 10 weeks' duration comparing the efficacy
of sertraline, 50 mg/day; sertraline, 100 mg/day; and fluoxetine,
20 mg/day, was conducted in 44 psychiatric outpatients with
DSM-IV unipolar major depressive disorder. Antidepressant dosages
were doubled at 6 weeks for subjects who had not achieved
remission. Primary outcome measurements included the 21-item
Hamilton Rating Scale for Depression (HAM-D) and the Clinical
Global Impressions-Improvement scale (CGI-I), with scores of
<= 7 on the HAM-D and <= 2 on the CGI-I representing a
positive treatment response, i.e., remission.
Results: At 4 weeks, significant differences in
rate of positive treatment response were noted, with 0% for
sertraline, 50 mg; 46% for sertraline, 100 mg; and 31% for
fluoxetine, 20 mg (p = .023). At 6 weeks, positive treatment
response rates were 21%, 43%, and 31% for subjects taking 50 mg
of sertraline, those taking 100 mg of sertraline, and those
taking 20 mg of fluoxetine, respectively, with treatment groups
no longer differing significantly from each other. In subjects
for whom antidepressant dose was doubled at week 6, response
rates at week 10 (4 weeks on increased dose) were 40% for
sertraline, 100 mg; 43% for sertraline, 200 mg; and 55% for
fluoxetine, 40 mg.
Conclusion: Subjects taking sertraline, 100 mg,
and fluoxetine, 20 mg, demonstrated an earlier treatment response
compared with subjects taking sertraline, 50 mg. For patients
without a positive response at 6 weeks, an increased
antidepressant dose resulted in remission for a substantial
proportion of patients when assessed 4 weeks later.