PHARMACOTHERAPY IN NEUROTIC DEPRESSION

Abstract

A 4-week double-blind controlled study comparing fluphenazine, amitriptyline and a combination of both drugs as to their depression-relieving properties was conducted with 71 social class V clinic and 60 social class III and IV general practice neurotic depressed patients. Significant population differences in clinical improvement were observed, with higher social class general practice patients improving more than lower social class clinic patients in almost all improvement criteria. While all 3 drugs produced almost identical improvement in general practice, in the clinic population fluphenazine was in several measures, particularly in a cluster reflecting somatic complaints, significantly less effective than either drug combination or amitriptyline. Only on the Zung scale did the drug combination appear to be significantly better than amitriptyline. Comparing the present results with placebo responses observed in 2 similar populations, placebo responses are similar in clinic and general practice patients, despite differences in social class and all 3 drugs differed significantly from placebo in general practice, while only drug combination and amitriptyline, but not fluphenazine did so in the clinic population. Fluphenazine produced the least and drug combination the most side reactions, which, however, were usually mild and of short duration. Population differences in type of reported side reactions and in attrition rates were found. Data are discussed in terms of population as well as drug X population interaction effects.