THE IMPACT OF SERTRALINE, DESIPRAMINE, AND PLACEBO ON PSYCHOMOTOR FUNCTIONING IN DEPRESSION

Impairment of psychomotor performance is a common adverse effect of ma ny antidepressants, particularly tricyclics. Desipramine is thought to be an exception, with possible performance enhancing effects on psych omotor function. This multicentre study examined the relative effects on psychomotor function of sertraline versus desipramine versus placeb o in mild to moderate depression. Fifty-eight patients who satisfied D SM-III-R criteria for major depression and had a minimum HAM-D score o f 15 (17 items) completed eight weeks of treatment. They underwent a s tandardized assessment which included depression and anxiety rating sc ales (HAM-D, HAM-A, MADRS) and a battery of psychomotor performance te sts (The Simple and Choice Reaction Time, The Digit Symbol Substitutio n and The Trail Making Test), before, during, and after eight weeks of treatment with sertraline, desipramine, or placebo. At baseline, ther e was a trend for both the sertraline and placebo groups to exhibit be tter psychomotor performance than desipramine. No significant differen ces were found between groups after treatment nor between groups for t he change from baseline to week 8. However, at week 3, the sertraline group performed significantly better in the trail making test than the placebo patients (p<0.05). Within each treatment group, there was a t rend towards improvement in performance for all four parameters from b aseline to the end of the study, with these improvements being most ob vious in the desipramine group. Sertraline, however, was found to be a ssociated with significantly fewer other adverse effects than the desi pramine group, i.e. sweating, dry mouth, anorexia. These results sugge st that desipramine and sertraline do not adversely affect psychomotor performance and may even enhance it in mild to moderately depressed p atients.