The efficacy of fluoxetine versus maprotiline in depressed patients and by dose

The aim of this trial was to study the antidepressant effect, to ascertain the optimal dose, and to assess the safety profile of the 5-HT reuptake inhibitor fluoxetine as compared with the noradrenaline reuptake inhibitor maprotiline in a randomized, double-blind, multicentre study in three psychiatric university clinics in Finland. In- and out-patients of either sex, aged 18 to 65 years, and fulfilling Research Diagnostic Criteria for unipolar, major depressive disorders were included. Altogether 46 patients were included, 24 in the fluoxetine group and 22 in the maprotiline group. Twenty-one patients in the former and 18 in the latter group completed the trial. The fluoxetine dose was fixed at 20 mg/day during the first 3 weeks of the study, followed by a 2-week flexible dose period with a dose range from 20 to 60 mg daily. The maprotiline dose was flexible, ranging from 50 to 150 mg/day during the total study period. The patients were assessed before and after the washout period and weekly during the 5...