Differential effectiveness of newer and older antidepressants appears mediated by an age effect on the phenotypic expression of depression.
OBJECTIVE
A possible mechanism whereby the serotonin reuptake inhibitor (SSRI) antidepressants may not (overall) be as effective as the tricyclic (TCA) antidepressants is explored.


METHODS
Clinical psychiatrists rated the effectiveness of past antidepressant medications in a clinical panel study of patients with a major depressive disorder, with 200 having previously received a TCA and 219 an SSRI.


RESULTS
Analyses indicated decreased SSRI effectiveness with age in those with the melancholic subtype. TCA effectiveness appeared uninfluenced by age and depressive subtype.


CONCLUSIONS
Findings suggest why the broader-based TCAs may be more effective than the SSRIs in implicating age and depressive subtype influences.
School of Psychiatry, University of New South Wales, and Mood Disorders Unit, Prince of Wales Hospital, Sydney, Australia. g.parker@unsw.edu.au
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D000328:Adult; D000367:Age Factors; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors