Conclusions : International differences in prescriber behaviour may influence , and in turn be influenced by , the conduct of clinical trials .
Objective : International differences are thought to exist in dosages used by clinicians treating mood disorders .
This study examined international dosage differences in antidepressant clinical trials , using a data base formed and maintained as a component of a Cochrane review of comparative clinical trials of fluoxetine .
[The study of the efficacy of fluoxetine versus tianeptine in the treatment of elderly depressed patients followed in general practice].
Depression in the elderly appears to be frequently poorly understood and underdiagnosed . The frequency of depressed illness in subjects over the age of 65 years is an important problem of health care . General practitioners are often in the first line of care . The objective of this trial was to compare the efficacy and safety of fluoxetine 20 mg/day to tianeptine 37.5 mg/day in elderly patients suffering from major depressive episode defined according to DSM III-R criteria , Newcastle Depression Scale < or = -20 , without associated dementia Mini Mental Status ( MMSE ) , treated by general practitioners in ten different french regions during 3 months . 237 patients were r and omised , each patient had to be treated for 12 weeks and was review ed 5 times during the trial . Patients had signed an informed consent . This trial was in favor of the superiority of fluoxetine compared to tianeptine . The main criterium , defined as the difference of the Montgomery and Asberg Depression Rating scale ( MADRS ) score between day 0 and day 84 , was significantly different in favour of the fluoxetine group ( intent to treat and per protocol analysis ) ( p = 0.019 ) . The success rate at the end of the treatment ( MADRS < or = 10 ) was significantly higher in the fluoxetine group ( fluoxetine group : 48.4 % vs tianeptine group : 28.1 % ) ( p = 0.005 ) . These results were confirmed by analysis of the other assessment criteria Geriatric Depression Scale ( GDS ) and Clinical Global Impression ( CGI ) . During the study , the safety of the two treatments was comparable
Conclusions : International differences in prescriber behaviour may influence , and in turn be influenced by , the conduct of clinical trials .
Objective : International differences are thought to exist in dosages used by clinicians treating mood disorders .
This study examined international dosage differences in antidepressant clinical trials , using a data base formed and maintained as a component of a Cochrane review of comparative clinical trials of fluoxetine .