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A differential response to nortriptyline and fluoxetine in melancholic depression: the importance of age and gender
Author(s) -
Joyce P. R.,
Mulder R. T.,
Luty S. E.,
McKenzie J. M.,
Rae A. M.
Publication year - 2003
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1034/j.1600-0447.2003.00120.x
Subject(s) - nortriptyline , fluoxetine , psychology , antidepressant , melancholia , rating scale , depression (economics) , psychiatry , amitriptyline , serotonin reuptake inhibitor , clinical psychology , melancholic depression , reuptake inhibitor , medicine , serotonin , developmental psychology , cognition , anxiety , receptor , economics , macroeconomics
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, age18–24 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.