کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
6234994 | 1608180 | 2012 | 7 صفحه PDF | دانلود رایگان |
ObjectiveTo investigate to what extent the primary depression subtype atypical depression can predict differential outcome of the mono-amino-oxidase inhibitor (MAO-I) moclobemide and the tricyclic antidepressant clomipramine in the Danish University Antidepressant Group Study (DUAG).MethodsIn a randomised, double blind trial, a total of 117 patients with major depression were treated over 6Â weeks with either 400Â mg moclobemide or 150Â mg clomipramine. A baseline principal component analysis (PCA) was performed to identify atypical symptoms on the combined depression scales (Hamilton Depression Scale (HAM-D17) and the Quantitative Scale for Atypical Depression (QSAD)). The primary outcome scale was the subscale HAM-D6 which contains the pure items of depression.ResultsPCA identified two items with loadings opposite to the other depression items within HAM-D17 and QSAD, namely increased duration of sleep and increased appetite (atypical neurovegetative symptoms). Patients with a positive score at baseline on these items were classified as having atypical depression. In total 13 patients were classified as having atypical depression. Within this group of patients 8 received clomipramine and 5 patients received moclobemide. At endpoint the moclobemide treated patients had a significantly better response than the clomipramine treated (PÂ =Â 0.036), effect size 1.42, when using HAM-D6 as outcome. However, in the 104 patients classified as having typical depression clomipramine was superior to moclobemide (PÂ =Â 0.034), effect size 0.47.LimitationsThe number of patients with atypical neurovegetative symptoms was very small and no placebo arm was included.ConclusionsIt is very important to screen for atypical depression (increased duration of sleep/increased appetite) in the acute therapy of patients with major depression. Our results add to the body of evidence that monoamine oxidase inhibitors are superior to tricyclic antidepressants in this sub-group of patients.
Journal: Journal of Affective Disorders - Volume 140, Issue 3, November 2012, Pages 253-259