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A double-blind randomized study comparing imipramine with fluvoxamine in depressed inpatients
Walter W van den Broek1, Tom K Birkenhäger, Paul G H Mulder
1Department of Psychiatry, Erasmus Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands. w.w.vandenbroek@erasmusmc.nl
Psychopharmacology
|July 10, 2004
Summary
In a study of depressed inpatients, imipramine demonstrated greater efficacy compared to fluvoxamine. Both antidepressant medications were well-tolerated, suggesting imipramine may be a more effective treatment option.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Depressive disorders represent a significant global health burden.
- Pharmacological interventions are a cornerstone of depression treatment.
- Comparing the efficacy of different antidepressant medications is crucial for optimizing patient care.
Purpose of the Study:
- To compare the efficacy of imipramine versus fluvoxamine in hospitalized patients diagnosed with depressive disorder.
- To evaluate treatment outcomes based on standardized diagnostic criteria (DSM IV).
Main Methods:
- A randomized controlled trial involving 141 inpatients diagnosed with depressive disorder (DSM IV criteria).
- Patients were randomized to receive either imipramine or fluvoxamine after a 1-week placebo run-in.
- Drug dosages were adjusted to achieve target blood levels, with efficacy assessed after 4 weeks of adequate plasma levels.
Main Results:
- Imipramine treatment resulted in a significantly greater improvement in illness severity scores (CGI) compared to fluvoxamine (P=-0.048).
- A significantly larger mean reduction in Hamilton Rating Scale for Depression (HRSD) scores was observed with imipramine (P=0.033).
- No significant differences were found in achieving a 50% or greater reduction on the HRSD or in the number of patients with HRSD scores ≤7.
Conclusions:
- Imipramine is more efficacious than fluvoxamine in treating depressed inpatients.
- Both imipramine and fluvoxamine were well-tolerated by the study participants.
- Findings suggest imipramine may be a preferred treatment option for inpatient depression.