Sertraline safety and efficacy in major depression: A double-blind fixed-dose comparison with placebo

In a 6-week, randomized, double-blind, multicenter trial, sertraline 50 mg, 100 mg, or 200 mg, or placebo, was administered once daily to 369 patients with DSM-III-defined major depression. Efficacy variables included changes from baseline scores for total Hamilton Rating Scale for Depression (HAMD), HAMD Bech Depression Cluster, Clinical Global Impressions (CGI) Severity, CGI Improvement, and Profile of Mood States Depression/Dejection Factor. For the evaluable-patients analysis, all sertraline groups showed significantly (p < 0.05 or better) greater improvements in all efficacy variables except one when compared with the placebo group. For the all-patients analysis, all efficacy variables in the 50 mg group were statistically significantly (p < 0.05) better than placebo. Side effects increased with increasing dosage but were usually mild and well tolerated. The results of this study show that sertraline 50 mg once daily is as effective as higher dosages for the treatment of major depression with fewer side effects and therapy discontinuations.

[1]  J. Rosenbaum,et al.  Fluoxetine-induced sexual dysfunction. , 1990, The Journal of clinical psychiatry.

[2]  G. Kennett,et al.  Antidepressant-like action of 5-HT1A agonists and conventional antidepressants in an animal model of depression. , 1987, European journal of pharmacology.

[3]  R. Zerbe,et al.  Fixed-dose fluoxetine therapy for depression. , 1987, Psychopharmacology bulletin.

[4]  R. G. Browne,et al.  Sertraline, 1S,4S-N-methyl-4-(3,4-dichlorophenyl)-1,2,3,4-tetrahydro-1-naphthylamine, a new uptake inhibitor with selectivity for serotonin. , 1983, The Journal of pharmacology and experimental therapeutics.

[5]  Johnson Am,et al.  The pharmacologic profile of paroxetine, a new selective serotonin reuptake inhibitor. , 1992 .

[6]  R. Fuller,et al.  Use of specific serotonin uptake inhibitors as antidepressants. , 1985, Clinical neuropharmacology.

[7]  John M. Davis,et al.  Biogenic amine hypothesis of affective disorders , 1979 .

[8]  M. Hamilton A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[9]  B. Koe,et al.  Sertraline, a selective inhibitor of serotonin uptake, induces subsensitivity of beta-adrenoceptor system of rat brain. , 1987, European journal of pharmacology.

[10]  Bernstein Jg Psychotropic drug induced weight gain: mechanisms and management. , 1988 .

[11]  D. Weidler,et al.  Gas chromatographic-mass spectrometric analysis and preliminary human pharmacokinetics of sertraline, a new antidepressant drug. , 1987, Journal of chromatography.

[12]  P. Soloff Neuroleptic treatment in the borderline patient: advantages and techniques. , 1987, The Journal of clinical psychiatry.

[13]  J. Zajecka,et al.  The role of serotonin in sexual dysfunction: fluoxetine-associated orgasm dysfunction. , 1991, The Journal of clinical psychiatry.

[14]  G. Dunbar,et al.  Optimal dose regimen for paroxetine. , 1992, The Journal of clinical psychiatry.

[15]  L. Fabre,et al.  A fixed-dose clinical trial of fluoxetine in outpatients with major depression. , 1987, The Journal of clinical psychiatry.

[16]  H. Lehmann,et al.  A double-blind, placebo-controlled dose-finding study with sertraline. , 1989, Psychopharmacology bulletin.

[17]  S. Enna,et al.  Antidepressants : neurochemical, behavioral, and clinical perspectives , 1981 .

[18]  E. Richelson,et al.  Blockade by newly-developed antidepressants of biogenic amine uptake into rat brain synaptosomes. , 1993, Life sciences.

[19]  P. Bech,et al.  QUANTITATIVE RATING OF DEPRESSIVE STATES , 1975, Acta psychiatrica Scandinavica.

[20]  T M Itil,et al.  Antidepressant efficacy of sertraline: a double-blind, placebo- and amitriptyline-controlled, multicenter comparison study in outpatients with major depression. , 1990, The Journal of clinical psychiatry.

[21]  K. Rickels,et al.  Clinical overview of serotonin reuptake inhibitors. , 1990, The Journal of clinical psychiatry.

[22]  Musher Js Anorgasmia with the use of fluoxetine. , 1990 .

[23]  Douglas A. Wolfe,et al.  Nonparametric Statistical Methods , 1973 .

[24]  J. Rabkin,et al.  Effects of antidepressant medication on sexual function: a controlled study. , 1986, Journal of clinical psychopharmacology.