Comparison between noradrenergic and serotonergic medications using the social adjustment scale: is drive enhancement necessary for recovery of social functioning?
The Social Adjustment Scale (SAS) was used to assess social functioning sequentially over 13 weeks in a group of 188 depressed outpatients randomized to either the noradrenergic antidepressant, nortriptyline, or the selective serotonin reuptake inhibitor, fluoxetine. Over the period of 13 weeks, there were no differences in total SAS scores between the nortriptyline and the fluoxetine group. In comparing the SAS subscale scores, which may measure different areas of motivation and behaviour (drive), there were differences between the two groups in only two subscales. At 13 weeks, the group randomized to fluoxetine were more impaired in marital role (p = 0.026) whereas, at 6 weeks, the group randomized to nortriptyline were more impaired in friction scores (p = 0.012). These results do not support the concept of specific augmentation of drive-related behaviour by noradrenergic medication. This challenges the earlier findings relating to drive enhancement and social adjustment using such medication.
Luty
S E
SE
Department of Psychological Medicine, Christchurch School of Medicine, New Zealand. sue.luty@chmeds.ac.nz
Joyce
P R
PR
Mulder
R T
RT
D018663:Adrenergic Agents / Q000627:therapeutic use*; D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D008019:Life Style; D008297:Male; D009638:Norepinephrine / Q000502:physiology*; D009661:Nortriptyline / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000187:drug effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012917:Social Adjustment; D016896:Treatment Outcome
D018663:Adrenergic Agents; D018759:Adrenergic Uptake Inhibitors; D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D005473:Fluoxetine; D009638:Norepinephrine; D009661:Nortriptyline; D017367:Selective Serotonin Reuptake Inhibitors