Background
We examined two previously published studies comparing a norepinephrine (NE) selective
agent, reboxetine, and a serotonin (5-HT) selective agent, fluoxetine, to determine
if these agents have different effects on individual depressive symptoms.
Methods
Both studies were 8-week, double-blind, comparison studies of men and women with DSM
III-R major depression. Within-group effect sizes for individual symptom change on
the Hamilton Depression Rating Scale (HAMD) were determined in the observed case samples
and in patients for whom the symptom was relatively severe at baseline. We required
that any significant differences in one sample be cross-validated in the second.
Results
Two hundred fifty-three subjects in study I and 168 subjects in study II were randomized
to reboxetine or fluoxetine. In both samples, depressed mood, decreased interest,
and psychic anxiety had the greatest change. Effect sizes for all HAMD symptoms were
similar for the two drugs. No difference between groups in one sample was replicated
in the second. Among subjects with severe symptoms, no significant differences were
cross-validated.
Conclusions
Reboxetine and fluoxetine appear to have similar effects on depressive symptoms. These
data suggest that NE and 5-HT selective antidepressant drugs act through the same
final common pathway and challenge the belief that symptom differences are useful
for antidepressant selection.
Key Words
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Article info
Publication history
Published online: May 09, 2005
Accepted:
March 15,
2005
Received in revised form:
January 31,
2005
Received:
August 10,
2004
Identification
Copyright
© 2005 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
