title: Sertraline is more effective than imipramine in the treatment of non-melancholic depression: results from a multicentre, randomized study.
abstract: The acute treatment efficacy, tolerability, and effects on health-related quality of life of sertraline (50-200 mg/day) versus imipramine (75-225 mg/day) were compared in outpatients with non-melancholic depression. The study employed an open-label, parallel-group design. One hundred and sixteen patients were randomized to receive sertraline and 123 to receive imipramine for 8 weeks. In the intent-to-treat (ITT), last-observation-carried-forward (LOCF) analysis, sertraline produced statistically significantly greater improvements in depressive (21-item Hamilton Depression Rating Scale [HAM-D(21)] scores of 24.9 and 24.4 were reduced to 10.3 and 13.1 at endpoint, P<.005) and anxiety symptoms (Hamilton Anxiety Rating Scale [HAM-A] scores of 21.8 and 21.9 were reduced to 9.5 and 13.9, P<.01), as well as in response (69.0% versus 53.7% at endpoint, P=.016) and remission rates (51.3% versus 38.0% at endpoint, P=.041) from week 4 onwards compared with imipramine. The proportion of patients who were 'very much improved' or 'much improved' (Clinical Global Impressions Scale of Improvement [CGI-I] score of 1 or 2) was significantly higher at endpoint in the sertraline group (76.1%) than in the imipramine group (62.8%) (P=.028). At week 8, patients in both treatment groups showed clear improvements in quality of life, although nonstatistically significant differences were evident in the quality of life of sertraline- versus imipramine-treated patients. Sertraline was significantly superior in tolerability with less discontinuations due to adverse events (10.3%) compared with the imipramine group (24.4%) (P=.004). It was concluded that sertraline is more effective than imipramine in the acute treatment of depressive and anxiety symptoms in patients with non-melancholic depression.
authors.affiliation: Department of Psychiatry, Hospital Puerta de Hierro, Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Baca
authors.forename: Manuel
authors.initials: M
authors.lastname: González de Chávez
authors.forename: Mauro
authors.initials: M
authors.lastname: García-Toro
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez-Arnau
authors.forename: Alberto
authors.initials: A
authors.lastname: Porras-Chavarino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D019263:Dysthymic Disorder / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D007099:Imipramine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020280:Sertraline / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D007099:Imipramine; D020280:Sertraline