Zimelidine vs maprotiline in depressed outpatients. A preliminary report

Outpatients with endogenous depression diagnosed according to the research diagnostic criteria of Feighner et al. were randomly referred to treatment with zimelidine (100 mg b.i.d., group Z) or maprotiline (75 mg b.i.d., group M). Patients who did not respond to treatment by days 28 were crossed over to the other drug. This preliminary report comprises results up to day 28 and includes antidepressive effect as rated by CPRS and globally, side effects, clinical chemistry and ECG. Ratings were double-blind at days 0, 7, 14 and 28, and a washout period of 4--7 days preceeded the trial. Group Z includes 27 and group M 28 patients with equal distribution of sex, age, duration of present episode, initial severity, etiology and previous course. There were 11 dropouts in group M and 5 in group Z due to side effects or treatment failure. On the other hand, 8 patients in group Z had to cross over to the other drug versus 2 in group M. According to the total CPRS score and the global score the antidepressive effect was somewhat better in group Z at 2 weeks but similar at 1 and 4 weeks. Group Z is less sedative but still seems to have a better anti-anxiety effect. Side effects were on a low level. There was a greater number of patients in group Z who complained of nausea, vomiting, loose stools, sleep disorder and sweating, and in group M dry mouth, drowsiness, dizziness and accomodation difficulties. Chemical analyses and ECG showed slight and inconsistent changes.