The effects of fluoxetine and dothiepin on cognitive function in depressedpatients in general practice

The objective of this study was to assess whether there are any differences between fluoxetine and dothiepin on cognitive function of patients with ma jor depression (DSMIII-R). A randomized, double-blind, parallel group desig n, 6 week trial in patients in general practice was employed where patients were randomly allocated to one of two treatment groups, i.e. fluoxetine 20 mg mane or dothiepin 75 mg nocte (increasing to 150 mg in the 2nd week). E ighty-four depressed patients aged 18-70 (mean 43.8) years were admitted to the study. Cognitive function was assessed by a valid battery of tests bef ore and during treatment. The severity of depression was assessed using the Hamilton Depression Rating Scale (HAMD) at the start and end of the study. Both treatments were similarly efficacious in reducing the HAMD and perfor mance tended to improve with both drugs during treatment. There were signif icant differences between the drugs on the critical flicker fusion task whe re the fluoxetine group performed significantly better than the dothiepin g roup (p < 0.05). The fluoxetine group also had better scores on a mental ar ithmetic task. No significant differences were observed in the adverse even t profiles. The results of this study show that fluoxetine and dothiepin ca nnot be differentiated in terms of efficacy manifest by changes in the HAMD , but do possess different profiles of action on the battery of cognitive t ests. Copyright (C) 1999 John Wiley & Sons, Ltd.