Fluvoxamine as effective as clomipramine against symptoms of severe depression: Results from a multicentre, double-blind study

Joseph Zohar, Harman Keegstra, Lucien Barrelet

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Although selective serotonin reuptake inhibitors (SSRIs) are better tolerated than tricyclic antidepressants, their efficacy in severe depression remains to be further elucidated. Method. A double-blind, multicentre study was conducted in 86 severely depressed inpatients (≥ 25 on the 17-item Hamilton depression rating scale [HAMD] total score) to compare the efficacy and safety of fluvoxamine with that of clomipramine. Following placebo run-in, 86 patients were randomised to receive fluvoxamine or clomipramine (100-250 mg/day) for 8 weeks. Results. Fluvoxamine and clomipramine both resulted in marked improvements;there were no statistically significant differences between them on the 17-item HAMD total score, the clinical global impression severity of illness or global improvement items or the Montgomery-Åsberg depression rating scale, at any visit. At the end of the study, 71% in the fluvoxamine group and 69% in the clomipramine group were responders (≥ 50% decrease in 17-item HAMD total score). However, fluvoxamine was better tolerated than clomipramine. Clomipramine was associated with a higher incidence of overall and treatment-related adverse events. In addition, the percentage of patients discontinued prematurely due to adverse events was more than twice as high with clomipramine than with fluvoxamine (24% vs 11%). Conclusion. Fluvoxamine and clomipramine are equally effective in severe depression, but fluvoxamine has a better safety and tolerability profile.

Original languageEnglish
Pages (from-to)113-119
Number of pages7
JournalHuman Psychopharmacology
Volume18
Issue number2
DOIs
StatePublished - Mar 2003
Externally publishedYes

Keywords

  • Clomipramine
  • Fluvoxamine
  • Selective serotonin reuptake inhibitor
  • Severe depression

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