Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by McGrath, P. J. Articles by Klein, D. F. Search for Related Content PubMed Citation Articles by McGrath, P. J. Articles by Klein, D. F. Depression Antidepressants

A Placebo-Controlled Study of Fluoxetine Versus Imipramine in the Acute Treatment of Atypical Depression

OBJECTIVE: The atypical subtype of depression appears to be both well validated and common. Although monoamine oxidase inhibitors are effective in treating atypical depression, their side effects and prescription-associated dietary restrictions reduce their suitability as a first-line treatment. The objective of this study was to estimate the efficacy of the selective serotonin reuptake inhibitor (SSRI) fluoxetine in the treatment of major depression with atypical features. METHOD: One hundred fifty-four subjects with DSM-IV major depression who met the Columbia criteria for atypical depression were randomly assigned to receive fluoxetine, imipramine, or placebo for a 10-week clinical trial. Imipramine was included because its known efficacy for treatment of atypical depression helped to calibrate the appropriateness of the study group. RESULTS: In both intention-to-treat and completer groups, the effectiveness of both fluoxetine and imipramine was significantly better than that of placebo. The two medications did not differ from each other in effectiveness. Significantly more patients dropped out of treatment with imipramine than with fluoxetine. Before treatment, patients on average rated themselves as very impaired on psychological dimensions of general health and moderately impaired on physical dimensions, compared with population norms. The self-ratings of patients who responded to treatment essentially normalized on these measures. CONCLUSIONS: Despite earlier data that SSRIs might be the treatment of choice, fluoxetine appeared to be no better than imipramine in the treatment of atypical depression, although fluoxetine was better tolerated than imipramine.

This article has been cited by other articles:

				J. A. Israel Remission in depression: definition and initial treatment approaches. J Psychopharmacol, May 1, 2006; 20(3 Suppl): 5 - 10. [Abstract] [PDF]

				P. Stolk, M. J ten Berg, M. E. Hemels, and T. R Einarson Meta-Analysis of Placebo Rates in Major Depressive Disorder Trials Ann. Pharmacother., December 1, 2003; 37(12): 1891 - 1899. [Abstract] [Full Text] [PDF]

				L. S. Matza, D. A. Revicki, J. R. Davidson, and J. W. Stewart Depression With Atypical Features in the National Comorbidity Survey: Classification, Description, and Consequences Arch Gen Psychiatry, August 1, 2003; 60(8): 817 - 826. [Abstract] [Full Text] [PDF]

				F. M. Quitkin, E. Petkova, P. J. McGrath, B. Taylor, C. Beasley, J. Stewart, J. Amsterdam, M. Fava, J. Rosenbaum, F. Reimherr, et al. When Should a Trial of Fluoxetine for Major Depression Be Declared Failed? Am J Psychiatry, April 1, 2003; 160(4): 734 - 740. [Abstract] [Full Text] [PDF]

				F. M. QUITKIN, P. J. McGRATH, J. W. STEWART, and D. F. KLEIN A Reappraisal of Atypical Depression Am J Psychiatry, April 1, 2003; 160(4): 798 - 800. [Full Text] [PDF]

				F. M. Quitkin, J. W. Stewart, P. J. McGrath, B. P. Taylor, M. S. Tisminetzky, E. Petkova, Y. Chen, G. Ma, and D. F. Klein Are There Differences Between Women's and Men's Antidepressant Responses? Am J Psychiatry, November 1, 2002; 159(11): 1848 - 1854. [Abstract] [Full Text] [PDF]

				G. Parker, K. Roy, P. Mitchell, K. Wilhelm, G. Malhi, and D. Hadzi-Pavlovic Atypical Depression: A Reappraisal Am J Psychiatry, September 1, 2002; 159(9): 1470 - 1479. [Abstract] [Full Text] [PDF]

				R. C. Shelton and A. J. Tomarken Can Recovery From Depression Be Achieved? Psychiatr Serv, November 1, 2001; 52(11): 1469 - 1478. [Abstract] [Full Text] [PDF]

				F. M. QUITKIN, J. W. STEWART, P. J. MCGRATH, and D. F. KLEIN Classifying Depression Am J Psychiatry, August 1, 2001; 158(8): 1332 - 1333. [Full Text] [PDF]

				How Do SSRIs and TCAs Stack Up Against Each Other? Journal Watch Psychiatry, May 1, 2000; 2000(501): 3 - 3. [Full Text]

Get information about faster international access.

Privacy Policy

Copyright © 2000 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us