Changes in energy during treatment of depression: An analysis of fluoxetine in double-blind, placebo-controlled trials

More than two thirds of patients with depression present with symptoms of f atigue, low energy, and Listlessness. Because daytime sedation may be a con cern in such patients, a "nonsedating" antidepressant should be considered. The authors examined the effects of fluoxetine on depression-related distu rbances in energy. Data from seven double-blind, placebo-controlled clinica l trials in 2,075 patients with major depression were retrospectively analy zed. The Hamilton Rating Scale for Depression (HAM-D) Retardation factor sc ore (total of items 1, 7, 8, and 14) was used as the primary measure of ene rgy improvement, whereas the HAM-D-17 total score was used to assess change s in overall depression. Elderly patients (aged 60 years and older) were in cluded in the overall group and were also analyzed separately. In addition, a subgroup analysis was performed using the HAM-D Retardation factor score to categorize patients as having low (score < 8) or high (score <greater t han or equal to> 8) levels of retardation at baseline, Beginning at week 3, fluoxetine-treated patients experienced statistically significant reductio ns in their HAM-D Retardation factor score compared with placebo-treated pa tients. The reductions for the elderly subgroup were less than those for th e overall population, but they mere still statistically significant beginni ng at week 4, Patients in both the low and high baseline retardation groups improved significantly. HAM-D-17 total scores for fluoxetine-treated patie nts in all groups (total, elderly, high retardation, and low retardation) i mproved significantly compared with placebo-treated patients. These finding s demonstrate that fluoxetine-treated patients experience an improvement in energy symptoms as their overall depression improves.