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Query: UMLS:C0043352 (xerostomia)
 4,250 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The safety and efficacy of nortriptyline and fluoxetine were compared in a double-blind, randomized, multicenter 5-week trial involving 205 outpatients with acute major depression of moderate severity. Seventy-two nortriptyline and 84 fluoxetine patients completed at least 2 weeks of medication and were included in the efficacy analysis; all patients were evaluated for side effects. Average total scores on the Hamilton Rating Scale for Depression (HAM-D) for both treatment groups declined from 22-23 at baseline to 11.5 at the conclusion of the 5-week period. At Week, 5, 71% of nortriptyline patients and 65% of fluoxetine patients were much or very much improved. Fluoxetine was associated more frequently with nausea (p less than .05), while nortriptyline was associated more frequently with dry mouth (p less than .05). These results are discussed in the context of selecting between nortriptyline and fluoxetine for a particular depressed patient.
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PMID:Comparative efficacy and safety of nortriptyline and fluoxetine in the treatment of major depression: a clinical study. 205 Jun 51

Fluoxetine, a selective serotonin uptake inhibitor (mean dose 73 mg each morning) was compared with amitriptyline (mean dose 122 mg at night) in a double-blind study of 64 depressed out-patients. Fifty patients completed the 6-week trial. The drugs did not differ with respect to psychiatrists' ratings, but amitriptyline was slightly superior with respect to patients' ratings. The amitriptyline-treated group had complaints of dry mouth and dizziness on standing; the fluoxetine-treated group of sleep disturbances, nausea, and headaches.
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PMID:A controlled comparison of fluoxetine and amitriptyline in depressed out-patients. 332 68

Fluoxetine was compared to doxepin in geriatric out-patients with major depressive illness. At the end of the 6-week double-blind study, the mean endpoint scores for all rating scales were significantly improved over base-line in both treatment groups. A subsequent 48-week open-label study supported the finding that both drugs are efficacious for maintenance therapy in elderly depressed patients. Fluoxetine, which lacks anticholinergic effects and is nonsedating, was well-tolerated by most patients and had fewer total side effects than doxepin. Common drug-related side effects for fluoxetine included nervousness/anxiety and nausea. Common side effects of doxepin were dry mouth, drowsiness/sedation, constipation, and dizziness/lightheadedness.
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PMID:Double-blind comparative trials of fluoxetine and doxepin in geriatric patients with major depressive disorder. 388 76

Fluoxetine and imipramine were compared in a six-week, double-blind, randomized trial in 118 men and women, ages 18 to 70 years, hospitalized for major depressive disorder. Treatment groups were comparable at baseline. Median maintenance doses were: fluoxetine, 80 mg/day; imipramine, 200 mg/day. Efficacy with fluoxetine and imipramine was comparable: none of the between-treatment differences was statistically significant. Mean +/- standard deviation baseline HAMD21 total scores and change (last-visit-carried-forward analysis), respectively, were fluoxetine, 28.0 +/- 5.3 and -8.5 +/- 9.9; imipramine, 27.0 +/- 5.8 and -11.9 +/- 9.0. Response and remission rates, respectively, were fluoxetine, 54.5 and 21.2%; imipramine, 60.0 and 34.3%. Discontinuations for adverse events were comparable (fluoxetine, 21.4%; imipramine, 22.6%). Common treatment-emergent events with fluoxetine were dry mouth (28.6%), constipation (17.9%), and somnolence (17.9%); those with imipramine were dry mouth (58.1%), constipation (32.3%), and headache (22.6%). Fluoxetine was as effective as imipramine in this population of inpatients.
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PMID:Fluoxetine compared with imipramine in the treatment of inpatient depression. A multicenter trial. 828 Dec 43

Cardiovascular adverse effects are amongst the most serious observed with antidepressant drugs and are often due to effects on cardiac conduction and refractoriness. However, such electrophysiologic effects may not be evident when using conventional electrocardiographic measures. Forty patients with major depressive disorder (according to DSM-III-R criteria) were enrolled in a 6-week double-blind parallel group study of fluoxetine (N = 20) or doxepin (N = 20). Cardiac conduction (QRS duration) and repolarization (corrected QT interval, QTc), were measured using signal-averaged electrocardiograms and 12-lead electrocardiogram at baseline and after 2, 4, and 6 weeks of treatment. Patients taking doxepin (mean daily dosage at 6 weeks 169 +/- 42 mg) were similar to those taking fluoxetine (37 +/- 18 mg) for demographic variables and improvement in depression scores but volunteered more side effects (p = 0.011), especially dry mouth (p < 0.001) and dizziness/lightheadedness (p = 0.005). After 6 weeks, doxepin increased heart rate (69 +/- 12 to 81 +/- 13 beats per minute; p = 0.0003) and prolonged QTc (from 417 +/- 36 to 439 +/- 28 msec; p < 0.03); overall QRS duration was not prolonged but was correlated with serum doxepin concentrations (r = 0.78, p < 0.0001). Fluoxetine had no effect on QTc (428 +/- 24 msec at baseline vs. 430 +/- 24 msec at 6 weeks) or QRS duration (97 +/- 12 msec at baseline vs. 94 +/- 12 msec at 6 weeks). The standard 12-lead electrocardiogram showed no significant change in QRS or QTc for either drug. Using a sensitive measure of electrocardiographic effects, doxepin prolongs repolarization and may slow cardiac conduction. Fluoxetine has no measurable electrocardiographic effects, which suggests an increased safety margin for cardiac adverse effects. The ability of the signal-averaged electrocardiogram to resolve small changes in the electrocardiogram is useful in the assessment of drugs with subtle electrophysiologic effects.
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PMID:Electrocardiographic effects of fluoxetine and doxepin in patients with major depressive disorder. 900 52

The objective of this study was to compare, in a naturalistic setting, the efficacy and tolerability of currently available Selective Serotonin Reuptake Inhibitors (SSRIs) and venlafaxine in outpatients at a primary psychiatric care centre in Spain. The sample was composed of 194 patients with mood disorders (major depressive disorder or dysthymic disorder according to the DSM-TV criteria) who began treatment either with an SSRI (fluoxetine, fluvoxamine, paroxetine, sertraline, and citalopram) or with venlafaxine. Baseline severity of the mood disorder was assessed using the Hamilton Depression Rating Scale and State-Trait Anxiety Inventory, and therapeutic response was measured with the Clinical Global Impression for Therapeutic Improvement. Tolerability was assessed by recording spontaneously reported adverse experiences. There were no significant differences in the efficacy of the antidepressants under study, but there were differences in the incidence and profiles of adverse events. Fluoxetine was associated with the lowest incidence of adverse effects, in a logistical regression model, but particular events seemed to be associated with certain treatments: gastrointestinal discomfort (fluvoxamine), tremor (sertraline), dry mouth and dizziness (venlafaxine) and sweating and nervousness (citalopram). We conclude that in clinical practice there are differences in the tolerability of these antidepressants. Studies with bigger samples are needed to confirm these findings.
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PMID:Comparative efficacy and tolerability among different selective serotonin re-uptake inhibitors and venlafaxine in a naturalistic setting. 2492 88

The selective serotonin reuptake inhibitors (SSRIs) have the best established tolerance and safety profile of the available antidepressants. Evidence for this conclusion comes from controlled clinical trials, post-marketing surveillance, prescription audits and case reports. Comparative studies are sparse within the class of SSRIs, and methodological differences between studies are problematic, yet certain differences emerge in tolerability when comparing placebo-adjusted incidence rates for the most common adverse events. Fluoxetine commonly produces nervousness, anxiety, insomnia and headache. Sexual dysfunction is more common with sertraline. Dry mouth can occur from paroxetine, and gastrointestinal effects (cramps, diarrhoea) from sertraline. The incidence of nausea appears to be no greater for any particular drug, especially after several weeks of treatment. Hyponatraemia and extrapyramidal side effects are rare events reported with all SSRIs. General guidelines are given for choosing an initial SSRI according to adverse effect profile; however, inter-subject variability exists in the expression of adverse effects, as well as intra-subject variability during treatment, suggesting the development of pharmacodynamic tolerance. Thus, rational selection of an SSRI on the basis of comparative tolerability is possible, but largely empirical without further scientific evidence from clinical trials specifically designed to differentiate drugs according to their adverse effect profile.
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PMID:Comparative safety and tolerability of selective serotonin reuptake inhibitors. 2956 15