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Treatment strategy in depression
Author(s) -
Nolen W. A.,
Putte J. J. van de,
Dijken W. A.,
Kamp J. S.,
Blansjaar B. A.,
Kramer H. J.,
Haffmans J.
Publication year - 1988
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 - 10.1111/j.1600-0447.1988.tb06402.x
Subject(s) - fluvoxamine , tricyclic , reuptake inhibitor , serotonergic , antidepressant , crossover study , fluoxetine , depression (economics) , medicine , psychology , serotonin , pharmacology , psychiatry , anxiety , receptor , alternative medicine , macroeconomics , pathology , economics , placebo
Antidepressants are ineffective in about 30% of patients with major depression. Some authors then advise treatment of non‐responders with (non‐tricyclic) more selective reuptake inhibitors. In a double‐blind, partial crossover study, 71 patients were selected for treatment during 4 weeks with oxaprotiline and/or fluvoxamine, two non‐tricyclic antidepressants that are selective reuptake inhibitors of noradrenaline and serotonin respectively. All patients had failed to respond to earlier treatment with cyclic antidepressants during the current episode. Only 13% of the patients responded, with 27% of them responding to oxaprotiline and none to fluvoxamine. Moreover, a low response of 27% was also obtained in the crossover phase, which included all non‐responders to the first treatment, oxaprotiline being effective in 39% and fluvoxamine in 10% of the patients. The results indicate that selective reuptake inhibitors are not an effective alternative for non‐responders to other cyclic antidepressants and that non‐responders to “nor‐adrenergic” antidepressants do not appear to have much chance of responding to “serotonergic” antidepressants and vice versa.