Differential efficacy of escitalopram and nortriptyline on dimensional measures of depression

Rudolf Uher; Wolfgang Maier; Joanna Hauser; Andrej Marusic; Christine Schmael; Ole Mors; Neven Henigsberg; Daniel Souery; Anna Placentino; Marcella Rietschel; Astrid Zobel; Monika Dmitrzak-Weglarz; Ana Petrovic; Lisbeth Jorgensen; Petra Kalember; Caterina Giovannini; Mara Barreto; Amanda Elkin; Sabine Landau; Anne Farmer; Katherine J. Aitchison; Peter McGuffin

doi:10.1192/bjp.bp.108.057554

Differential efficacy of escitalopram and nortriptyline on dimensional measures of depression

Rudolf Uher, Wolfgang Maier, Joanna Hauser, Andrej Marusic, Christine Schmael, Ole Mors, Neven Henigsberg, Daniel Souery, Anna Placentino, Marcella Rietschel, Astrid Zobel, Monika Dmitrzak-Weglarz, Ana Petrovic, Lisbeth Jorgensen, Petra Kalember, Caterina Giovannini, Mara Barreto, Amanda Elkin, Sabine Landau, Anne FarmerKatherine J. Aitchison, Peter McGuffin

Research output: Contribution to journal › Article › peer-review

167 Citations (Scopus)

Abstract

Background Tricyclic antidepressants and serotonin reuptake inhibitors are considered to be equally effective, but differences may have been obscured by internally inconsistent measurement scales and inefficient statistical analyses. Aims To test the hypothesis that escitalopram and nortriptyline differ in their effects on observed mood, cognitive and neurovegetative symptoms of depression. Method In a multicentre part-randomised open-label design (the Genome Based Therapeutic Drugs for Depression (GENDEP) study) 811 adults with moderate to severe unipolar depression were allocated to flexible dosage escitalopram or nortriptyline for 12 weeks. The weekly Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, and Beck Depression Inventory were scored both conventionally and in a more novel way according to dimensions of observed mood, cognitive symptoms and neurovegetative symptoms. Results Mixed-effect linear regression showed no difference between escitalopram and nortriptyline on the three original scales, but symptom dimensions revealed drug-specific advantages. Observed mood and cognitive symptoms improved more with escitalopram than with nortriptyline. Neurovegetative symptoms improved more with nortriptyline than with escitalopram. Conclusions The three symptom dimensions provided sensitive descriptors of differential antidepressant response and enabled identification of drug-specific effects.

Original language	English
Pages (from-to)	252 - 259
Number of pages	8
Journal	British Journal of Psychiatry
Volume	194
Issue number	3
DOIs	https://doi.org/10.1192/bjp.bp.108.057554
Publication status	Published - Mar 2009

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Uher, R., Maier, W., Hauser, J., Marusic, A., Schmael, C., Mors, O., Henigsberg, N., Souery, D., Placentino, A., Rietschel, M., Zobel, A., Dmitrzak-Weglarz, M., Petrovic, A., Jorgensen, L., Kalember, P., Giovannini, C., Barreto, M., Elkin, A., Landau, S., ... McGuffin, P. (2009). Differential efficacy of escitalopram and nortriptyline on dimensional measures of depression. British Journal of Psychiatry, 194(3), 252 - 259. https://doi.org/10.1192/bjp.bp.108.057554

@article{61e4ab0e4f284d5d8892ff443575e192,

title = "Differential efficacy of escitalopram and nortriptyline on dimensional measures of depression",

abstract = "Background Tricyclic antidepressants and serotonin reuptake inhibitors are considered to be equally effective, but differences may have been obscured by internally inconsistent measurement scales and inefficient statistical analyses. Aims To test the hypothesis that escitalopram and nortriptyline differ in their effects on observed mood, cognitive and neurovegetative symptoms of depression. Method In a multicentre part-randomised open-label design (the Genome Based Therapeutic Drugs for Depression (GENDEP) study) 811 adults with moderate to severe unipolar depression were allocated to flexible dosage escitalopram or nortriptyline for 12 weeks. The weekly Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, and Beck Depression Inventory were scored both conventionally and in a more novel way according to dimensions of observed mood, cognitive symptoms and neurovegetative symptoms. Results Mixed-effect linear regression showed no difference between escitalopram and nortriptyline on the three original scales, but symptom dimensions revealed drug-specific advantages. Observed mood and cognitive symptoms improved more with escitalopram than with nortriptyline. Neurovegetative symptoms improved more with nortriptyline than with escitalopram. Conclusions The three symptom dimensions provided sensitive descriptors of differential antidepressant response and enabled identification of drug-specific effects.",

author = "Rudolf Uher and Wolfgang Maier and Joanna Hauser and Andrej Marusic and Christine Schmael and Ole Mors and Neven Henigsberg and Daniel Souery and Anna Placentino and Marcella Rietschel and Astrid Zobel and Monika Dmitrzak-Weglarz and Ana Petrovic and Lisbeth Jorgensen and Petra Kalember and Caterina Giovannini and Mara Barreto and Amanda Elkin and Sabine Landau and Anne Farmer and Aitchison, {Katherine J.} and Peter McGuffin",

year = "2009",

month = mar,

doi = "10.1192/bjp.bp.108.057554",

language = "English",

volume = "194",

pages = "252 -- 259",

journal = "British Journal of Psychiatry",

issn = "1472-1465",

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Uher, R, Maier, W, Hauser, J, Marusic, A, Schmael, C, Mors, O, Henigsberg, N, Souery, D, Placentino, A, Rietschel, M, Zobel, A, Dmitrzak-Weglarz, M, Petrovic, A, Jorgensen, L, Kalember, P, Giovannini, C, Barreto, M, Elkin, A, Landau, S , Farmer, A , Aitchison, KJ & McGuffin, P 2009, 'Differential efficacy of escitalopram and nortriptyline on dimensional measures of depression', British Journal of Psychiatry, vol. 194, no. 3, pp. 252 - 259. https://doi.org/10.1192/bjp.bp.108.057554

TY - JOUR

T1 - Differential efficacy of escitalopram and nortriptyline on dimensional measures of depression

AU - Uher, Rudolf

AU - Maier, Wolfgang

AU - Hauser, Joanna

AU - Marusic, Andrej

AU - Schmael, Christine

AU - Mors, Ole

AU - Henigsberg, Neven

AU - Souery, Daniel

AU - Placentino, Anna

AU - Rietschel, Marcella

AU - Zobel, Astrid

AU - Dmitrzak-Weglarz, Monika

AU - Petrovic, Ana

AU - Jorgensen, Lisbeth

AU - Kalember, Petra

AU - Giovannini, Caterina

AU - Barreto, Mara

AU - Elkin, Amanda

AU - Landau, Sabine

AU - Farmer, Anne

AU - Aitchison, Katherine J.

AU - McGuffin, Peter

PY - 2009/3

Y1 - 2009/3

N2 - Background Tricyclic antidepressants and serotonin reuptake inhibitors are considered to be equally effective, but differences may have been obscured by internally inconsistent measurement scales and inefficient statistical analyses. Aims To test the hypothesis that escitalopram and nortriptyline differ in their effects on observed mood, cognitive and neurovegetative symptoms of depression. Method In a multicentre part-randomised open-label design (the Genome Based Therapeutic Drugs for Depression (GENDEP) study) 811 adults with moderate to severe unipolar depression were allocated to flexible dosage escitalopram or nortriptyline for 12 weeks. The weekly Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, and Beck Depression Inventory were scored both conventionally and in a more novel way according to dimensions of observed mood, cognitive symptoms and neurovegetative symptoms. Results Mixed-effect linear regression showed no difference between escitalopram and nortriptyline on the three original scales, but symptom dimensions revealed drug-specific advantages. Observed mood and cognitive symptoms improved more with escitalopram than with nortriptyline. Neurovegetative symptoms improved more with nortriptyline than with escitalopram. Conclusions The three symptom dimensions provided sensitive descriptors of differential antidepressant response and enabled identification of drug-specific effects.

AB - Background Tricyclic antidepressants and serotonin reuptake inhibitors are considered to be equally effective, but differences may have been obscured by internally inconsistent measurement scales and inefficient statistical analyses. Aims To test the hypothesis that escitalopram and nortriptyline differ in their effects on observed mood, cognitive and neurovegetative symptoms of depression. Method In a multicentre part-randomised open-label design (the Genome Based Therapeutic Drugs for Depression (GENDEP) study) 811 adults with moderate to severe unipolar depression were allocated to flexible dosage escitalopram or nortriptyline for 12 weeks. The weekly Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, and Beck Depression Inventory were scored both conventionally and in a more novel way according to dimensions of observed mood, cognitive symptoms and neurovegetative symptoms. Results Mixed-effect linear regression showed no difference between escitalopram and nortriptyline on the three original scales, but symptom dimensions revealed drug-specific advantages. Observed mood and cognitive symptoms improved more with escitalopram than with nortriptyline. Neurovegetative symptoms improved more with nortriptyline than with escitalopram. Conclusions The three symptom dimensions provided sensitive descriptors of differential antidepressant response and enabled identification of drug-specific effects.

U2 - 10.1192/bjp.bp.108.057554

DO - 10.1192/bjp.bp.108.057554

M3 - Article

SN - 1472-1465

VL - 194

SP - 252

EP - 259

JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

IS - 3

ER -

Differential efficacy of escitalopram and nortriptyline on dimensional measures of depression

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