Fluvoxamine for Depression in General Practice Efficacy is similar for young and elderly but side effects are more common in the latter

6258 patients, aged 18-89 (mean 46) years, with a Montgomery-Asberg Depression Rating Scale score ~ 21 (mean 30) received fluvoxamine 50-300 mgjday for 6 weeks in an open trial. Patients were referred from 1895 general practitioners and 6 related study protocols were used. 73% of the patients were women and 29% had previously received antidepressants. Concomitant medications were more frequently taken by patients aged ~ 60 years than those aged 18-59 years.

633 patients were excluded for protocol violation. Montgomery-Asberg score decreased from a mean baseline of 30 to 24, 17 and 10 at weeks 1, 2 and 6, respectively. Psychosomatic symptom scale scores decreased from a mean baseline of 10.6 to 8.6, 6.1 and 3.7 at weeks 1, 2 and 6. respectively. Clinical global improvement at week 1 was mimmally Improved in 41% of patients and much improved in 18%. By week 2, 41% were much improved and 15% very much improved. At week 6, 37% of patients were much improved and 47% very much improved. At week 1, 20% of patients reported adverse effects and this decreased to 8% at week 6. 912 patients withdrew from the study because of adverse effects Adverse effects reported by patients included nausea (13%), headache (5"/o), dizziness (5%), somnolence (4%). dry mouth (4%), vomiting (4%), asthenia (3%), insomnia (3%), diarrhoea (3%), abdominal pain (2%) tremor (2%), dyspepsia (2%), palpitations (1%) and anorexia (1%) 20 overdoses with fluvoxamine. none of which were fatal, were reported.

The authors concluded that ' ... compliance to fluvoxamine was good in this large general practice population and the risk/benefit ratio favourable for its use in this area'.

Marlin Au Tebt" VM Ashford JJ Pharma!herapeu!1ca 5: 40·69 'Jo 1 1987

12 INPHARMA' 20 June 1987 0156-2703j87j0620-0012j0$01.00j0 © AOIS Press