Moclobemide and fluoxetine in atypical depression: a double-blind trial

The effectiveness of moclobemide or fluoxetine in the treatment of atypical (n = 53) and other depressive patients (n = 156) was compared in a 6-week double-blind randomized trial. HDRS, MARDS, GCI and the Atypical Depression Diagnostic Scale were used in clinical assessment. Significant differences were seen in MADRS and GCI scores in favour of moclobemide in the treatment of atypical depression, but not with HDRS. No major differences were seen between the two drugs in the treatment of other depressive patients. A positive response, defined by a > 50% decrease in HDRS score and a GCI Improvement Score of 1 or 2, was seen among 67% of atypical patients treated with moclobemide and among 55% treated with fluoxetine and in 60 and 48% of other depressive patients, respectively. Both drugs gave results with atypical patients at least as good as with other depressive patients. Our results suggest that patients suffering from atypical depression may respond more favourably to moclobemide than to fluoxetine treatment.