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Fluoxetine versus phenelzine in atypical depression
A C Pande1, M Birkett, S Fechner-Bates
1University of Michigan Department of Psychiatry, Ann Arbor, USA.
Biological Psychiatry
|November 15, 1996
Summary
Fluoxetine and phenelzine showed similar effectiveness for atypical depression. Fluoxetine was better tolerated, causing fewer side effects than phenelzine in this mood-reactive depression study.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Atypical depression, characterized by mood reactivity, presents unique treatment challenges.
- Selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) are treatment options, but direct comparisons are valuable.
Purpose of the Study:
- To compare the efficacy and tolerability of fluoxetine (an SSRI) versus phenelzine (an MAOI) in patients with mood-reactive atypical depression.
Main Methods:
- A randomized, double-blind, placebo-controlled study involving 42 patients diagnosed with atypical depression.
- Participants received either fluoxetine (20-60 mg/day) or phenelzine (45-90 mg/day) for six weeks after a placebo lead-in period.
- Efficacy was assessed using the Hamilton Depression Rating Scale and Clinical Global Impression scales.
Main Results:
- Treatment response rates were comparable between the fluoxetine and phenelzine groups.
- Phenelzine was associated with a higher incidence of adverse effects compared to fluoxetine, with tremor being a notable exception.
- The majority of patients completed the six-week study period.
Conclusions:
- Fluoxetine demonstrates comparable efficacy to phenelzine in treating atypical depression.
- Fluoxetine offers a better tolerability profile and fewer adverse effects, making it a potentially preferred treatment option.