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Course of psychomotor agitation during pharmacotherapy of depression: Analysis from double‐blind controlled trials with fluoxetine
Author(s) -
Tollefson Gary D.,
Sayler Mary E.
Publication year - 1996
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/(sici)1520-6394(1996)4:6<294::aid-da6>3.0.co;2-c
Subject(s) - fluoxetine , psychomotor learning , placebo , psychomotor agitation , pharmacotherapy , antidepressant , tricyclic antidepressant , hamilton rating scale for depression , psychomotor retardation , serotonin reuptake inhibitor , depression (economics) , anesthesia , psychology , psychomotor disorder , psychiatry , reuptake inhibitor , medicine , major depressive disorder , mood , anxiety , serotonin , cognition , receptor , alternative medicine , macroeconomics , pathology , economics
Psychomotor agitation, a common clinical feature of major depression, may first emerge or intensify during pharmacotherapy. Whether agitation is part of the underlying course of depression or iatrogenic complicates treatment planning. We analyzed data from blinded clinical trials involving 4,737 patients with major depression assigned to a selective serotonin reuptake inhibitor (fluoxetine), a comparator antidepressant (usually a tricyclic antidepressant [TCA]), or placebo. Item 9 of the Hamilton Depression Rating Scale was used to assess the degree of psychomotor agitation. The vast majority of depressed patients exhibited baseline psychomotor agitation. The rate of increased agitation from baseline during acute pharmacotherapy was comparable between fluoxetine and either placebo or TCAs. Substantial emergence of psychomotor agitation also occurred at a similar incidence across the three treatment groups and typically appeared within the first 3 wk. Improvement in agitation was significantly more prominent ( P < 0.001) among fluoxetine‐treated than among placebo‐treated patients. Fluoxetine‐treated patients demonstrated numerically superior improvement rates compared with TCA‐treated patients; however, this difference was not significant. Data derived from this large series of clinical trials suggested no evidence that either fluoxetine or TCAs induced psychomotor agitation at rates exceeding the natural course of the disorder over time (placebo cohort). On the contrary, pharmacotherapy with either fluoxetine or TCAs was typically associated with diminished agitation, probably as part of the response pattern of depression. Depression and Anxiety 4:294–311, 1996/1997.© 1997 Wiley‐Liss, Inc.