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Acta Psychiatr Scand. 2003 Jul;108(1):20-3.

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

Author information

  • 1Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, PO Box 4345, Christchurch, New Zealand. peter.joyce@chmeds.ac.nz

Abstract

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, age 18-24 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.

PMID:
12807373
[PubMed - indexed for MEDLINE]
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