Are there differences between serotonergic, noradrenergic and dual acting antidepressants in the treatment of depressed women?
BACKGROUND
This study aims to investigate if there is a differential outcome of serotonergic and noradrenergic antidepressant treatment and if menopausal status has an impact on antidepressant response in depressed women.


METHODS
Data of the 111 depressed women who were included and completed the previous four open-label studies where patients were evaluated six times during a 10-week period, were pooled in the current study. Each of the reboxetine, sertraline and venlafaxine groups consisted of 37 depressed women. Patients were also divided into two subgroups of age, determining the 44 years as the cut-off point representing the menopausal status.


RESULTS
No significant difference was observed in the percent change of Hamilton Depression Rating Scale-17 (HDRS) and remission rates among treatment groups. Percent changes in Clinical Global Impression-Severity of Illness scale (CGI-S) and response rates were in favour of venlafaxine group at week 10. Individual HDRS items 2, 3, 4, 5 and 6 demonstrated significant improvement in the sertraline group, whereas HDRS item 7 demonstrated significant improvement in the venlafaxine group. An early reduction in anxiety subscale was observed in the venlafaxine group. Menopausal status had no impact on the outcome measures.


CONCLUSIONS
These results suggest that noradrenergic and serotonergic activity do not differ from each other in treating depressed women. However, serotonergic activity appears to be more prominent in some particular symptoms such as feelings of guilt, suicidal ideation and sleep. Also, menopause does not appear to affect antidepressants' benefit in depressed women.
Eker
Salih Saygin
SS
Department of Psychiatry, Uludag University Medical Faculty, Bursa, Turkey. saygineker@yahoo.com
Kirli
Selcuk
S
Akkaya
Cengiz
C
Cangur
Sengul
S
Sarandol
Asli
A
D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000367:Age Factors; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002979:Climacteric / Q000187:drug effects / Q000523:psychology; D002986:Clinical Trials as Topic; D003511:Cyclohexanols / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D009025:Morpholines / Q000009:adverse effects / Q000627:therapeutic use*; D010555:Personality Inventory; D000077593:Reboxetine; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D000069470:Venlafaxine Hydrochloride; D055815:Young Adult
D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D003511:Cyclohexanols; D009025:Morpholines; D000077593:Reboxetine; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline; D000069470:Venlafaxine Hydrochloride