Different gender response to serotonergic and noradrenergic antidepressants. A comparative study of the efficacy of citalopram and reboxetine.
BACKGROUND
It is well established that depressive disorders are more prevalent in women; however gender differences in the pharmacological response to antidepressants are not a consistent finding in all reports. It is considered that this discrepancy can be explained by the fact that in most clinical trials drug use for comparative purposes is not completely different. In this study gender differences in antidepressant response with citalopram (CTP), a selective serotonin reuptake inhibitor and reboxetine (RBX), a selective noradrenaline reuptake inhibitor were evaluated in a group of young men and premenopausal women.


METHODS
Eighty-six depressed patients 18 to 40 years old participated in an 8-week double-blind clinical trial. Subjects were divided in four groups according to sex and treatment assignation: females treated with CTP (n = 25) or RBX (n = 23), and males treated with CTP (n = 19) or RBX (n = 19). Response was determined using HDRS and BDI.


RESULTS
ANOVA analysis considering change in HDRS scores from baseline to last evaluation found a significant interaction between gender and type of treatment. Females treated with CTP showed a significantly greater response than females treated with RBX, while in men no differences were observed for both drugs.


CONCLUSIONS
Replication using larger sample size and longer treatment periods is required.


CONCLUSIONS
These results support previous findings which show that premenopausal women respond better than men to serotonergic antidepressants. They also support that a plausible interaction between gonadal hormones and serotonin may explain gender differences in antidepressant response.
Berlanga
Carlos
C
Instituto Nacional de Psiquiatría Ramón de la Fuente, Clinical Research Subdirection, Mexico. cisnerb@imp.edu.mx
Flores-Ramos
Mónica
M
D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D015283:Citalopram / Q000494:pharmacology / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D042341:Gonadal Hormones / Q000378:metabolism; D006801:Humans; D008297:Male; D009025:Morpholines / Q000494:pharmacology / Q000627:therapeutic use*; D017697:Premenopause / Q000187:drug effects; D000077593:Reboxetine; D012074:Remission Induction; D012701:Serotonin / Q000378:metabolism; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D012737:Sex Factors
D018759:Adrenergic Uptake Inhibitors; D015283:Citalopram; D042341:Gonadal Hormones; D009025:Morpholines; D000077593:Reboxetine; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors