PREDICTING THERAPEUTIC RESULTS WITH LEVOPROTILINE AND MAPROTILINE IN MAJOR DEPRESSION - THE ROLE OF THE OUTCOME CRITERIA

We describe a double-blind study involving 58 in-patients with major d epression (DSM-III). After one week on placebo, the patients were rand omly assigned to either levoprotiline or maprotiline treatment for thr ee weeks. In the next three weeks, responders were maintained on the s ame medication and non-responders were shifted to treatment with the c omplementary drug. After the initial three weeks' treatment, 31% of le voprotiline patients and 58% of maprotiline patients had responded. Bo th in the initial three-week treatment period and after shifting non-r esponders to the complementary drug, there were significant difference s in favour of maprotiline. The comparison of properties of different outcome criteria in prediction analyses shows that the final score giv es the best agreement with global evaluation; using the delta score (f inal minus baseline) or ratio score (final/baseline) as the outcome cr iterion may yield paradoxical results.