A differential response to nortriptyline and fluoxetine in melancholic depression: the importance of age and gender

Objective: To consider the impact of age and gender on the antidepressant response to nortriptyline and fluoxetine in melancholic depression. Method: Of 191 depressed patients, 113 met study criteria for melancholia. All patients were randomized to receive either fluoxetine or nortriptyline. Respons...

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Bibliographic Details
Published in:Acta psychiatrica Scandinavica 2003-07, Vol.108 (1), p.20-23
Main Authors: Joyce, P. R., Mulder, R. T., Luty, S. E., McKenzie, J. M., Rae, A. M.
Format: Article
Language:English
Subjects:
Adolescent
Adrenergic Uptake Inhibitors - therapeutic use
Adult
Age Factors
Antidepressive Agents, Second-Generation - therapeutic use
Biological and medical sciences
depression
Depressive Disorder - drug therapy
Depressive Disorder - psychology
Female
fluoxetine
Fluoxetine - therapeutic use
Humans
Logistic Models
Male
Medical sciences
melancholia
Neuropharmacology
nortriptyline
Nortriptyline - therapeutic use
Odds Ratio
Pharmacology. Drug treatments
Psychiatric Status Rating Scales
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Sex Factors
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Summary:Objective: To consider the impact of age and gender on the antidepressant response to nortriptyline and fluoxetine in melancholic depression. Method: Of 191 depressed patients, 113 met study criteria for melancholia. All patients were randomized to receive either fluoxetine or nortriptyline. Response rates, defined as an improvement of 60% or more on the Montgomery Asberg Depression Rating Scale over 6 weeks of antidepressant treatment on an intention to treat basis, were examined by age, and by age and gender. Results: Melancholic depressed patients 40 years or older, especially men, had a markedly superior response to nortriptyline compared with fluoxetine. Conversely, melancholic depressed patients, age18–24 years, especially women, had a markedly superior response to fluoxetine. Conclusion: Age and gender appear to be critical variables in understanding differential antidepressant responses to tricyclic antidepressants and selective serotonin reuptake inhibitors in melancholic depression.
ISSN:0001-690X
1600-0447
DOI:10.1034/j.1600-0447.2003.00120.x