Moclobemide versus fluoxetine in the treatment of inpatients with major depression.
Seventy inpatients with a DSM-III-R major depression were included in a double-blind, randomized, clinical trial to compare the efficacy and tolerability of moclobemide versus fluoxetine. After a 3-day placebo run-in phase, treatments were administered for 4 weeks in daily doses of between 300 and 600 mg of moclobemide or 20 to 40 mg of fluoxetine. Efficacy was measured by the Hamilton Rating Scale for Depression (HAM-D), Clinical Global Impression, and subjective mood ratings (45-item self-rating scale). Fifty-three patients (mean age, 40 years; 22 men, 31 women) completed the 4-week treatment. Changes between end of treatment and baseline did not differ between both study drugs. The HAM-D responder rate (50% improvement from baseline) was 59% in the moclobemide group and 58% in the fluoxetine group after 4 weeks. Moclobemide, however, acted therapeutically faster than fluoxetine. After 1 week of treatment, the HAM-D scores were significantly lower in patients on moclobemide than in those on fluoxetine (p < 0.005). The earlier efficacy of moclobemide after 1 week was also detected by the patients' subjective mood ratings (p < 0.02). There were no differences between moclobemide and fluoxetine regarding tolerability ratings. These data suggest that both agents have a similar efficacy and tolerability but that moclobemide has an earlier onset of antidepressive action.
Gattaz
W F
WF
Neurobiology Unit, Central Institute of Mental Health, Mannheim, Germany.
Vogel
P
P
Kick
H
H
Kohnen
R
R
D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001549:Benzamides / Q000009:adverse effects / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020912:Moclobemide; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D000928:Antidepressive Agents; D001549:Benzamides; D005473:Fluoxetine; D020912:Moclobemide; D017367:Selective Serotonin Reuptake Inhibitors