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 .
Moclobemide versus fluoxetine for double depression: a randomized double-blind study.
The efficacy and tolerability of the selective reversible monoamine oxidase A inhibitor , moclobemide ( 300 mg/day ) and the selective serotonin uptake inhibitor , fluoxetine ( 200 mg/day ) , were compared in a six-week single-centre double-blind fixed-dose study in patients ( n = 42 ) with double depression ( DSM-III-R : dysthymia with superimposed major depressive episode ) using weekly assessment on the Hamilton depression rating scale ( HDRS-17 items ) and clinical global impression ( CGI ) scale . The primary efficacy outcome measure was a decrease > or = 50 % in end of treatment HDRS score , secondary measures were the mean total endpoint HDRS scores and percentages of CGI very good and good responses . Tolerability was measured by the frequency and severity of volunteered adverse events . There were no significant differences in secondary efficacy outcome measures , but more patients achieved a > or = 50 % decrease in HDRS score on moclobemide ( 71 % vs 38 % , p < 0.05 ) . The only adverse event was mild transient anxiety ( n = 1 ) with moclobemide . The results suggest that moclobemide and fluoxetine are equally well tolerated and at least similar in efficacy in double depression . Evidence that moclobemide may be more effective requires confirmation in a larger comparative study incorporating a placebo control group
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 .