Double‐blind multicenter comparison of fluvoxamine versus sertraline in the treatment of depressed outpatients

Charles B. Nemeroff, Philip T. Ninan, James Ballenger, R. Bruce Lydiard, John Feighner, William M. Patterson, John H. Greist

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Fluvoxamine and sertraline, both selective serotonin reuptake inhibitors (SSRIs), were compared in a 5-center, 7-week double-blind study in outpatients with major depression diagnosed by DSM-III-R criteria. Ninety-five patients were titrated from 50 to 150 mg/day of fluvoxamine (n = 49) or 50 to 200 mg/day of sertraline (n = 46). The mean dose administered in Weeks 3-7 was 123.8 mg/day for fluvoxamine, and 137.1 mg/day for sertraline. Forty-seven percent (47%) of fluvoxamine-treated patients and 30% of sertraline-treated patients were titrated to the maximum permissible dose. Fluvoxamine and sertraline were similarly effective in ameliorating depression as demonstrated by a mean reduction from baseline in the Hamilton Rating Scale for Depression (HAMD) total score of 10.61 ± 7.53 and 10.98 ± 6.08, respectively. Adverse events, mostly mild to moderate in severity, were reported for 93.5% of sertraline patients and 85.7% of fluvoxamine patients. The most common events in the sertraline group were insomnia (34.8%), headache (32.6%), diarrhea (23.9%), and ejaculatory difficulty (22.2% of males), and in the fluvoxamine group, nausea (30.6%), headache (26.5%), insomnia (26.5%), and somnolence (24.5%). Significantly more patients reported sexual dysfunction in the sertraline (28%) than in the fluvoxamine (10%) group. An uncharacteristically low dropout rate due to adverse events were observed in the sertraline group (2.2%) compared with the fluvoxamine group (18.4%). The rate of withdrawal due to adverse events in the fluvoxamine group (0-2 patients/center) was comparable to that in the sertraline group (1 patient) for four of the five centers; the fifth center had 4 withdrawals in the fluvoxamine group. The differences in clinical profile of these two SSRIs provided physicians with meaningful choices in antidepressant therapy attuned to individual patient characteristics.

Original languageEnglish (US)
Pages (from-to)163-169
Number of pages7
JournalDepression
Volume3
Issue number4
DOIs
StatePublished - 1995
Externally publishedYes

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Keywords

  • Depression
  • Double-blind
  • Fluvoxamine
  • Sertraline
  • Sexual dysfunction
  • Tolerability

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Nemeroff, C. B., Ninan, P. T., Ballenger, J., Lydiard, R. B., Feighner, J., Patterson, W. M., & Greist, J. H. (1995). Double‐blind multicenter comparison of fluvoxamine versus sertraline in the treatment of depressed outpatients. Depression, 3(4), 163-169. https://doi.org/10.1002/depr.3050030402