CONCLUSIONS This systematic review provides evidence for the efficacy of both SSRIs and TCAs in the treatment of chronic depression and showed a better acceptability of SSRIs
INTRODUCTION Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences .
This review examined the efficacy and acceptability of selective serotonin reuptake inhibitors ( SSRIs ) and tricyclic antidepressants ( TCAs ) in the treatment of chronic depression .
Additionally , the comparative effectiveness of the two types of antidepressants has been examined .
Sertraline is more effective than imipramine in the treatment of non-melancholic depression:: Results from a multicentre, randomized study
The acute treatment efficacy , tolerability , and effects on health-related quality of life of sertraline ( 50 - 200 mg/day ) versus imipramine ( 75 - 225 mg/day ) were compared in out patients with non-melancholic depression . The study employed an open-label , parallel-group design . One hundred and sixteen patients were r and omized to receive sertraline and 123 to receive imipramine for 8 weeks . In the intent-to-treat ( ITT ) , last-observation-carried-forward ( LOCF ) analysis , sertraline produced statistically significantly greater improvements in depressive ( 21-item Hamilton Depression Rating Scale [ HAM-D(21 ) ] scores of 24.9 and 24.4 were reduced to 10.3 and 13.1 at endpoint , P<.005 ) and anxiety symptoms ( Hamilton Anxiety Rating Scale [ HAM-A ] scores of 21.8 and 21.9 were reduced to 9.5 and 13.9 , P<.01 ) , as well as in response ( 69.0 % versus 53.7 % at endpoint , P=.016 ) and remission rates ( 51.3 % versus 38.0 % at endpoint , P=.041 ) from week 4 onwards compared with imipramine . The proportion of patients who were ' very much improved ' or ' much improved ' ( Clinical Global Impressions Scale of Improvement [ CGI-I ] score of 1 or 2 ) was significantly higher at endpoint in the sertraline group ( 76.1 % ) than in the imipramine group ( 62.8 % ) ( P=.028 ) . At week 8 , patients in both treatment groups showed clear improvements in quality of life , although nonstatistically significant differences were evident in the quality of life of sertraline- versus imipramine-treated patients . Sertraline was significantly superior in tolerability with less discontinuations due to adverse events ( 10.3 % ) compared with the imipramine group ( 24.4 % ) ( P=.004 ) . It was concluded that sertraline is more effective than imipramine in the acute treatment of depressive and anxiety symptoms in patients with non-melancholic depression
CONCLUSIONS This systematic review provides evidence for the efficacy of both SSRIs and TCAs in the treatment of chronic depression and showed a better acceptability of SSRIs
INTRODUCTION Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences .
This review examined the efficacy and acceptability of selective serotonin reuptake inhibitors ( SSRIs ) and tricyclic antidepressants ( TCAs ) in the treatment of chronic depression .
Additionally , the comparative effectiveness of the two types of antidepressants has been examined .