Differential efficacy of escitalopram and nortriptyline on dimensional measures of depression

被引：163

作者：

Uher, Rudolf ^{[2
]}

Maier, Wolfgang ^{[1
]}

Hauser, Joanna ^{[3
]}

Marusic, Andrej ^{[4
]}

Schmael, Christine ^{[5
]}

Mors, Ole ^{[6
]}

Henigsberg, Neven ^{[7
]}

Souery, Daniel ^{[8
]}

Placentino, Anna ^{[9
,10
]}

Rietschel, Marcella ^{[11
]}

Zobel, Astrid ^{[12
]}

Dmitrzak-Weglarz, Monika ^{[3
]}

Petrovic, Ana ^{[4
]}

Jorgensen, Lisbeth ^{[13
,14
]}

Kalember, Petra ^{[7
]}

Giovannini, Caterina ^{[9
,10
]}

Barreto, Mara ^{[8
]}

Elkin, Amanda ^{[2
]}

Landau, Sabine ^{[2
]}

Farmer, Anne ^{[2
]}

Aitchison, Katherine J. ^{[2
]}

McGuffin, Peter ^{[2
]}

机构：

[1] Univ Bonn, Dept Psychiat, D-5300 Bonn, Germany

[2] Kings Coll London, Inst Psychiat, London SE5 8AF, England

[3] Poznan Univ Med Sci, Lab Psychiat Genet, Poznan, Poland

[4] Inst Publ Hlth, Ljubljana, Slovenia

[5] Cent Inst Mental Hlth, Div Genet Epidemiol Psychiat, D-6800 Mannheim, Germany

[6] Aarhus Univ Hosp, Ctr Psychiat Res, Risskov, Denmark

[7] Univ Zagreb, Sch Med, Croatian Inst Brain Res, Zagreb 41000, Croatia

[8] Univ Libre Bruxelles, Erasme Acad Hosp, Dept Psychiat, Brussels, Belgium

[9] FBF, Ctr San Giovanni Dio, Biol Psychiat Unit, Brescia, Italy

[10] FBF, Ctr San Giovanni Dio, Dual Diag Ward IRCCS, Brescia, Italy

[11] Cent Inst Mental Hlth, Div Genet Epidemiol Psychiat, D-6800 Mannheim, Germany

[12] Univ Bonn, Dept Psychiat, D-5300 Bonn, Germany

[13] Aarhus Univ Hosp, Ctr Psychiat Res, Risskov, Denmark

[14] Aarhus Univ Hosp, Mood Disorders Res Unit, Risskov, Denmark

来源：

BRITISH JOURNAL OF PSYCHIATRY | 2009年 / 194卷 / 03期

关键词：

SEROTONIN REUPTAKE INHIBITOR; CLINICAL-TRIALS; TRICYCLIC ANTIDEPRESSANTS; MAJOR DEPRESSION; RATING-SCALE; SAMPLE-SIZE; METAANALYSIS; ASSOCIATION; IMPROVEMENT; CITALOPRAM;

D O I：

10.1192/bjp.bp.108.057554

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Background Tricyclic antidepressants and serotonin reuptake inhibitors are considered to be equally effective, but differences may have been obscured by internally inconsistent measurement scales and inefficient statistical analyses. Aims To test the hypothesis that escitalopram and nortriptyline differ in their effects on observed mood, cognitive and neurovegetative symptoms of depression. Method In a multicentre part-randomised open-label design (the Genome Based Therapeutic Drugs for Depression (GENDEP) study) 811 adults with moderate to severe unipolar depression were allocated to flexible dosage escitalopram or nortriptyline for 12 weeks. The weekly Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, and Beck Depression Inventory were scored both conventionally and in a more novel way according to dimensions of observed mood, cognitive symptoms and neurovegetative symptoms. Results Mixed-effect linear regression showed no difference between escitalopram and nortriptyline on the three original scales, but symptom dimensions revealed drug-specific advantages. Observed mood and cognitive symptoms improved more with escitalopram than with nortriptyline. Neurovegetative symptoms improved more with nortriptyline than with escitalopram. Conclusions The three symptom dimensions provided sensitive descriptors of differential antidepressant response and enabled identification of drug-specific effects.

引用

页码：252 / 259

页数：8

共 47 条

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