Skip to main content
Top
Published in: Clinical Drug Investigation 7/2016

01-07-2016 | Original Research Article

Comparing the Effects of Sertraline with Duloxetine for Depression Severity and Symptoms: A Double-Blind, Randomized Controlled Trial

Authors: Arash Mowla, Seyed Ali Dastgheib, Leila Razeghian Jahromi

Published in: Clinical Drug Investigation | Issue 7/2016

Login to get access

Abstract

Background and Objective

Selecting the most effective treatment for major depressive disorder (MDD) is a challenge for clinicians. The aim of this study was to compare the effects of sertraline with duloxetine on major depression signs and symptoms.

Methods

The trial was a 6-week, randomized, controlled, double-blind study. Sixty-three patients with diagnosis of MDD according to DSM-IV-TR criteria were randomly assigned to receive either duloxetine (31 patients) or sertraline (32 patients). The mean dosage of duloxetine was 55 mg/day (range 40–60 mg/day) and the mean dosage of sertraline was 146 mg/day (range 50–200 mg/day). Subjects were assessed at baseline, and at the end of week 6. Depression severity and symptoms were assessed by 21-item Hamilton Depression Rating Scale (HAM-D).

Results

Of 63 patients who were randomized to treatment, 54 patients including 28 in the sertraline group and 26 in the duloxetine group completed the trial. The HAM-D total score for both groups was significantly reduced at the end of the trial period without significant difference from each other (p = 0.463). Of the symptoms studied, psychomotor retardation, general somatic symptoms and sexual problems improved more in the duloxetine group. On the other hand, agitation, anxiety symptoms and hypochondriasis ameliorated better in the sertraline group. There was no difference between the two groups regarding the other symptoms.

Conclusions

Our study shows that the antidepressant mechanism of action has influence on its effects on different signs and symptoms. Clinician awareness of an antidepressant’s special effects can help in selecting appropriate medicine.
Literature
1.
go back to reference Mendlewich J. Optimizing antidepressant use in clinical practice: towards criteria for antidepressant selection. Br J Psychiatry. 2001;179(suppl):1–3.CrossRef Mendlewich J. Optimizing antidepressant use in clinical practice: towards criteria for antidepressant selection. Br J Psychiatry. 2001;179(suppl):1–3.CrossRef
2.
go back to reference Nelson JC, Kennedy JS, Pollock BG, et al. Treatment of major depression with nortriptyline and paroxetine in patients with ischemic heart disease. Am J Psychiatry. 1999;156(7):1024–8.PubMed Nelson JC, Kennedy JS, Pollock BG, et al. Treatment of major depression with nortriptyline and paroxetine in patients with ischemic heart disease. Am J Psychiatry. 1999;156(7):1024–8.PubMed
3.
go back to reference Mowla A, Ghanizadeh A, Pani A. A comparison of effects of fluoxetine and nortriptyline on the symptoms of major depressive disorder. J Clin Psychopharmacol. 2006;26(2):209–11.CrossRefPubMed Mowla A, Ghanizadeh A, Pani A. A comparison of effects of fluoxetine and nortriptyline on the symptoms of major depressive disorder. J Clin Psychopharmacol. 2006;26(2):209–11.CrossRefPubMed
4.
go back to reference Kim HM, Zivin K, Choe HM. Predictors of start of different antidepressants in patient charts among patients with depression. J Manag Care Spec Pharm. 2015;21(5):424–30.CrossRefPubMed Kim HM, Zivin K, Choe HM. Predictors of start of different antidepressants in patient charts among patients with depression. J Manag Care Spec Pharm. 2015;21(5):424–30.CrossRefPubMed
5.
go back to reference Montgomery SA. Is there a role for a pure noradrenergic drug in the treatment of depression? Eur Neuropsychopharmacol. 1997;7(suppl 1):S3–9.CrossRefPubMed Montgomery SA. Is there a role for a pure noradrenergic drug in the treatment of depression? Eur Neuropsychopharmacol. 1997;7(suppl 1):S3–9.CrossRefPubMed
6.
go back to reference Healy D, McMonagle T. The enhancement of social functioning as a therapeutic principle in the management of depression. J Psychopharmacol. 1997;11(suppl 4):S25–31.PubMed Healy D, McMonagle T. The enhancement of social functioning as a therapeutic principle in the management of depression. J Psychopharmacol. 1997;11(suppl 4):S25–31.PubMed
7.
go back to reference Montgomery SA. Selective serotonin reuptake inhibitors in the acute treatment of depression. In: Bloom FE, Kupfer DJ, editors. Psychopharmacology: the fourth generation of progress. New York: Raven; 1995. Montgomery SA. Selective serotonin reuptake inhibitors in the acute treatment of depression. In: Bloom FE, Kupfer DJ, editors. Psychopharmacology: the fourth generation of progress. New York: Raven; 1995.
8.
go back to reference Montgomery SA. The efficacy of fluoxetine as an antidepressant in the short and long term. Int Clin Psychopharmacol. 1989;4(suppl 1):113–9.PubMed Montgomery SA. The efficacy of fluoxetine as an antidepressant in the short and long term. Int Clin Psychopharmacol. 1989;4(suppl 1):113–9.PubMed
9.
go back to reference Karpa KD, Cavanaugh JE, Lakoski JM. Duloxetine pharmacology: profile of a dual monoamine modulator. CNS Drug Rev. 2002;8(4):361–76.CrossRefPubMed Karpa KD, Cavanaugh JE, Lakoski JM. Duloxetine pharmacology: profile of a dual monoamine modulator. CNS Drug Rev. 2002;8(4):361–76.CrossRefPubMed
10.
go back to reference Petersen T, Dording C, Neault NB, et al. A survey of prescribing practices in the treatment of depression. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26(1):177–87.CrossRefPubMed Petersen T, Dording C, Neault NB, et al. A survey of prescribing practices in the treatment of depression. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26(1):177–87.CrossRefPubMed
11.
go back to reference Lee P, Shu L, Xu X, et al. Once-daily duloxetine 60 mg in the treatment of major depressive disorder: multicenter, double-blind, randomized, paroxetine-controlled, non-inferiority trial in China, Korea, Taiwan and Brazil. Psychiatry Clin Neurosci. 2007;61(3):295–307.CrossRefPubMed Lee P, Shu L, Xu X, et al. Once-daily duloxetine 60 mg in the treatment of major depressive disorder: multicenter, double-blind, randomized, paroxetine-controlled, non-inferiority trial in China, Korea, Taiwan and Brazil. Psychiatry Clin Neurosci. 2007;61(3):295–307.CrossRefPubMed
12.
go back to reference Pigott TA, Prakash A, Arnold LM, Aaronson ST, Mallinckrodt CH, Wohlreich MM. Duloxetine versus escitalopram and placebo: an 8-month, double-blind trial in patients with major depressive disorder. Curr Med Res Opin. 2007;23(6):1303–18.CrossRefPubMed Pigott TA, Prakash A, Arnold LM, Aaronson ST, Mallinckrodt CH, Wohlreich MM. Duloxetine versus escitalopram and placebo: an 8-month, double-blind trial in patients with major depressive disorder. Curr Med Res Opin. 2007;23(6):1303–18.CrossRefPubMed
13.
go back to reference Nierenberg AA, Greist JH, Mallinckrodt CH, et al. Duloxetine versus escitalopram and placebo in the treatment of patients with major depres-sive disorder: onset of antidepressant action, a non-inferiority study. Curr Med Res Opin. 2007;23(3):401–16.CrossRefPubMed Nierenberg AA, Greist JH, Mallinckrodt CH, et al. Duloxetine versus escitalopram and placebo in the treatment of patients with major depres-sive disorder: onset of antidepressant action, a non-inferiority study. Curr Med Res Opin. 2007;23(3):401–16.CrossRefPubMed
14.
go back to reference Häuser W, Petzke F, Sommer C. Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome. J Pain. 2010;11:505–21.CrossRefPubMed Häuser W, Petzke F, Sommer C. Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome. J Pain. 2010;11:505–21.CrossRefPubMed
15.
go back to reference Jones CK, Peters SC, Shannon HE. Synergistic interactions between the dual serotonergic, noradrenergic reuptake inhibitor duloxetine and the non-steroidal anti-inflammatory drug ibuprofen in inflammatory pain in rodents. Eur J Pain. 2007;11(2):208–15.CrossRefPubMed Jones CK, Peters SC, Shannon HE. Synergistic interactions between the dual serotonergic, noradrenergic reuptake inhibitor duloxetine and the non-steroidal anti-inflammatory drug ibuprofen in inflammatory pain in rodents. Eur J Pain. 2007;11(2):208–15.CrossRefPubMed
16.
go back to reference Sanchez C, Reines EH, Montgomery SA. A comparative review of escitalopram, paroxetine, and sertraline: are they all alike? Int Clin Psychopharmacol. 2014;29(4):185–96.CrossRefPubMedPubMedCentral Sanchez C, Reines EH, Montgomery SA. A comparative review of escitalopram, paroxetine, and sertraline: are they all alike? Int Clin Psychopharmacol. 2014;29(4):185–96.CrossRefPubMedPubMedCentral
17.
go back to reference Hamilton M. Rating depressive patients. J Clin Psychiatry. 1980;41(12 part 2):21–4.PubMed Hamilton M. Rating depressive patients. J Clin Psychiatry. 1980;41(12 part 2):21–4.PubMed
18.
go back to reference Nelson JC, Clary CM, Leon AC, et al. Symptoms of late life depression: frequency and change during treatment. Am J Geriatr Psychiatry. 2005;13(6):520–6.CrossRefPubMed Nelson JC, Clary CM, Leon AC, et al. Symptoms of late life depression: frequency and change during treatment. Am J Geriatr Psychiatry. 2005;13(6):520–6.CrossRefPubMed
19.
go back to reference Nelson JC, Portera L, Leon AC. Are there differences in the symptoms that respond to a selective serotonin or norepinephrine reuptake inhibitor? Biol Psychiatry. 2005;57(12):1535–42.CrossRefPubMed Nelson JC, Portera L, Leon AC. Are there differences in the symptoms that respond to a selective serotonin or norepinephrine reuptake inhibitor? Biol Psychiatry. 2005;57(12):1535–42.CrossRefPubMed
20.
21.
go back to reference Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple treatments meta-analysis. Lancet. 2009;373:746–58.CrossRefPubMed Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple treatments meta-analysis. Lancet. 2009;373:746–58.CrossRefPubMed
22.
go back to reference Khoo AL, Zhou HJ, Teng M, et al. Network meta-analysis and cost-effectiveness analysis of new generation antidepressants. CNS Drugs. 2015;29(8):695–712.CrossRefPubMed Khoo AL, Zhou HJ, Teng M, et al. Network meta-analysis and cost-effectiveness analysis of new generation antidepressants. CNS Drugs. 2015;29(8):695–712.CrossRefPubMed
23.
go back to reference Grover S, Shah R, Dutt A, et al. Prevalence and pattern of sexual dysfunction in married females receiving antidepressants: an exploratory study. J Pharmacol Pharmacother. 2012;3(3):259–65.CrossRefPubMedPubMedCentral Grover S, Shah R, Dutt A, et al. Prevalence and pattern of sexual dysfunction in married females receiving antidepressants: an exploratory study. J Pharmacol Pharmacother. 2012;3(3):259–65.CrossRefPubMedPubMedCentral
24.
go back to reference Montgomery SA, Baldwin DS, Riley A. Antidepressant medications: a review of the evidence for drug-induced sexual dysfunction. J Affect Disord. 2002;69:119–40.CrossRefPubMed Montgomery SA, Baldwin DS, Riley A. Antidepressant medications: a review of the evidence for drug-induced sexual dysfunction. J Affect Disord. 2002;69:119–40.CrossRefPubMed
Metadata
Title
Comparing the Effects of Sertraline with Duloxetine for Depression Severity and Symptoms: A Double-Blind, Randomized Controlled Trial
Authors
Arash Mowla
Seyed Ali Dastgheib
Leila Razeghian Jahromi
Publication date
01-07-2016
Publisher
Springer International Publishing
Published in
Clinical Drug Investigation / Issue 7/2016
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-016-0399-6

Other articles of this Issue 7/2016

Clinical Drug Investigation 7/2016 Go to the issue