Differential effects of fluvoxamine, paroxetine and milnacipran for depression, especially with regard to age.
BACKGROUND
Selective serotonin reuptake inhibitors (SSRIs) and dual serotonin and noradrenaline reuptake inhibitors (SNRIs) are the most commonly prescribed classes of antidepressants, yet it is not known whether one is superior to the other. It seems that an investigation of the characteristics of patients being treated with SSRIs and SNRIs would be useful in determining which patients would be most likely to benefit from these antidepressant medications.


OBJECTIVE
The purpose of this retrospective study was to compare the response to fluvoxamine, paroxetine and milnacipran treatment for depression with regard to patient age.


METHODS
A retrospective cohort analysis was carried out among depression outpatients treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2001. A total of 159 patients who met the criteria and who were receiving fluvoxamine, paroxetine and milnacipran were identified. To examine the influence of antidepressants with regard to patient age, the response rate of patients aged 50 years or older was compared with that of those aged 49 years or younger.


RESULTS
In patients aged 49 years or younger, the clinical effect of fluvoxamine was greater than that of the other antidepressants. Conversely, in those aged 50 years or older, milnacipran had a tendency to be more effective than the others.


CONCLUSIONS
The differential response of SSRIs and SNRIs with regard to age should help to guide clinicians in determining the selection of antidepressants for depression.
Morishita
Shigeru
S
Depression Prevention Medical Center, Kyoto Jujo Hospital, 32 Kisshoinhattandacho, Minami-Ku, Kyoto 601-8325, Japan. s.morishita31@r9.dion.ne.jp
Arita
Seizaburo
S
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003521:Cyclopropanes / Q000627:therapeutic use*; D003863:Depression / Q000145:classification / Q000188:drug therapy*; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000078764:Milnacipran; D017374:Paroxetine / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D003521:Cyclopropanes; D016666:Fluvoxamine; D000078764:Milnacipran; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors