TREATMENT OF CHRONIC DEPRESSION WITH SERTRALINE OR IMIPRAMINE - PRELIMINARY BLINDED RESPONSE RATES AND HIGH-RATES OF UNDERTREATMENT IN THE COMMUNITY

Despite the prevalence of chronic depression and its associated morbid ity, there has been little systematic study of pharmacotherapy for thi s disorder, In this article, we report a preliminary analysis of the f irst 12-week phase of a multicenter clinical trial that will eventuall y include approximately 635 patients in acute, continuation, crossover , and maintenance studies of sertraline, a selective serotonin reuptak e inhibitor (SSRI), and imipramine, a tricyclic antidepressant, for th e treatment of chronic depression, Of the first 212 patients to enter the study, 168 completed all 12 weeks; of these, 61.3 percent were res ponders, including 58.9 percent of the 73 patients with chronic major depression and 63.2 percent of the 95 patients with double depression, Only 26.8 percent of the 198 patients for wham such data were availab le had ever had an adequate trial of an antidepressant medication, def ined as 150 mg/day of imipramine or its equivalent taken for at least 4 consecutive weeks, In general, demographic and diagnostic characteri stics were more similar than different for patients with chronic major and double depression, However, comorbid generalized anxiety disorder was significantly more common in patients with chronic major depressi on (11.2% threshold for chronic versus 4.9% threshold for double depre ssion, p=.02). The results of this study provide preliminary evidence of the responsiveness of patients with chronic major or double depress ion to an SSRI or a tricyclic antidepressant.