期刊
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY
卷 31, 期 5, 页码 577-581出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JCP.0b013e31822c091a
关键词
antidepressant; major depressive disorder; clinical trials; citalopram; sertraline
资金
- National Science Council [NSC 98-2314-B-075-004-MY2]
- Taipei Veterans General Hospital, Taiwan [VGH 98DHA0100505]
Several previous studies, including a meta-analysis, reported no significant differences between various selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder. However, because of the different chemical structure of SSRIs and the difference in the frequency of serotonin transporter polymorphisms between ethnic groups, a head-to-head comparative study between SSRIs in different populations may be enlightening. We compared the efficacy and adverse effect profiles of citalopram and sertraline in a double-blinded randomized clinical trial in a Chinese population of drug-naive patients with first-episode major depressive disorder. Fifty-one patients were randomly assigned to citalopram or sertraline treatment. The Montgomery-Asberg Depression Rating Scale (MADRS) was used as the primary outcome. Efficacy and adverse effects were analyzed in an intent-to-treat population. Efficacy was analyzed using a last-observation-carried-forward method for early terminators. There were no significant differences in demographic characteristics at baseline. No significant differences were found in MADRS scores between citalopram and sertraline at baseline (36.6 +/- 5.5 vs 38.2 +/- 4.9; P = 0.322) or at the end of treatment (week 6; 10.8 +/- 10.0 vs 16.7 +/- 11.3; P = 0.082). However, MADRS scores in the citalopram group were significantly lower at week 1 (25.2 +/- 8.5 vs 30.4 +/- 6.1; P = 0.029) and week 3 (15.9 +/- 10.0 vs 22.1 +/- 8.7; P = 0.037). Overall, treatment-emergent adverse effects were reported by 14.3% and 28.6% of patients in the citalopram and sertraline groups, respectively. In conclusion, citalopram and sertraline were both efficacious and well tolerated. However, citalopram exhibited a significantly faster onset than sertraline during the early weeks of treatment and tended to have a better efficacy in overall treatment, although the statistic was not significant.
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