A 12-week study comparing moclobemide and sertraline in the treatment of outpatients with atypical depression

One hundred and ninety-seven outpatients with atypical depression [Atypical Depression Diagnostic Scale (ADDS) score=4] were randomized to 12 weeks of double-blind treatment with sertraline or moclobemide in a multicentre, pa rallel-group clinical trial. Patients were started on either 50 mg/day sert raline or 300 mg/day moclobemide. If the therapeutic response was not satis factory after 4 weeks; the dose could be increased to either 100mg/day sert raline or 450mg/day moclobemide. Primary efficacy evaluations were the 29-i tem Hamilton Psychiatric Rating Scale for Depression (HAM-D) and the Clinic al Global Impression of Improvement (CGI-I) response rate (much or very muc h improved) at study endpoint. Secondary efficacy evaluations included the ADDS, the Hamilton Anxiety Scale (HAMA), the Leeds Sleep Scale, and the Bat telle Quality of Life Battery (BQOLB). In the analysis of the 172 patient e fficacy-evaluable population, there was significant baseline to endpoint im provement in all primary and secondary efficacy assessments after treatment ; with either sertraline or moclobemide. At the endpoint, the proportion of responde rs on CGI-I, was 77.5% in the? sertraline group and 67.5% in the moclobemide group (p=0.052). The baseline to endpoint mean 29-item HAM-D sc ore decreased from 35.9 to 14.5 in the sertraline group and from 36.3 to 16 .1 in the moclobemide group. Sertraline also resulted in a significantly (p <0.05) greater degree of improvement at the endpoint, compared with moclobe mide, in the proportion of remitters on the HAMA (total score less than or equal to 7), ADDS Category IID (Rejection Sensitivity), Leeds Sleep Factor 4 (Integrity of Behaviour following Awakening), and on three. dimensions of the BQOLB (Energy/Vitality, Social Interaction and Life Satisfaction). The re were no other significant differences between treatment groups. Overall, both medications were well tolerated, In this study, both sertraline and m oclobemide improved the symptoms of atypical depression.