[Comparative naturalistic study of the efficacy and tolerability of new antidepressants].
OBJECTIVE
The objective of this study was to compare, in a naturalistic setting, the efficacy and tolerability of currently available Selective Serotonin Re-uptake Inhibitors (SSRIs) and venlafaxine in out-patients from a primary psychiatric-care center.


METHODS
The sample was composed of 194 patients with mood disorders (major depressive disorder or dysthymic disorder according to the DSM-IV criteria) who initiated treatment either with a SSRI (fluoxetine, fluvoxamine, paroxetine, sertraline, and citalopram) or with venlafaxine. Baseline severity of the mood disorder was assessed using the Hamilton Depression Rating Scale and State-Trait Anxiety Inventory, and therapeutic response was measured with the Clinical Global Impression for Therapeutic Improvement. Tolerability was assessed by recording spontaneously reported adverse experiences. Patients were followed up for six months, with subjects made three o more intermediate visits.


RESULTS
There were no significant differences in the efficacy of the antidepressants under study, but there were differences in the incidence and profiles of adverse events. Fluoxetine was associated with the lowest incidence of adverse effects in a logistical regression model. Particular events seemed to be associated with certain treatments; gastrointestinal discomfort (fluvoxamine), tremor (sertraline) and anticholinergic effects (venlafaxine).
Arias
F
F
Unidad de Salud Mental, Centro de Salud Santa Elena, Zamora.
Padín
J J
JJ
Gilaberte
I
I
Varillas
P
P
Sánchez
R
R
Gómez
S
S
García
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index