Pattern of outcome with sertraline, imipramine, and des-venlafaxine in unipolar nonpsychotic depression

Abstract

Background: There is a scarcity of research on the temporal sequence of improvement with antidepressants and the differential effect of different antidepressants. Aims: To study the temporal sequence of improvement and differential pattern of outcome with antidepressants from different classes. Methods: 132 males and females from 18 to 65 years suffering from the first depressive episode were followed up at baseline, 3 rd day, 7 th day, 10 th day, 14 th day, 21 st day, 1 month, and 3 months using the 17 item Hamilton Rating Scale for Depression. Patients were randomized into three groups namely (1) sertraline (2) des-venlafaxine and (3) imipramine. Appropriate statistical analyses were applied. Results: The pattern of improvement was similar across the groups. The earliest improvement was seen in early insomnia (at day 3) followed by suicidal ideas and psychological anxiety (by day 7). Middle insomnia, late insomnia, and agitation improved by the 14 th day. Depressed mood improved significantly at day 14 th in the sertraline and imipramine groups and day 21 st in the des-venlafaxine group. Work and activities and retardation improved significantly in the sertraline and imipramine groups at 1 month. The last symptoms to improve were general somatic symptoms, genital symptoms, and guilt feeling. Conclusions: It is important to know the temporal sequence of symptomatic improvement with antidepressants as it will guide us to make important management decisions. It also helps to improve compliance as patients can be appropriately guided regarding expected course of treatment.

Keywords

• Antidepressants
• des-venlafaxine
• imipramine
• outcome
• sertraline
• temporal