Effects of gender difference on response to sertraline and imipramine in patients with chronic depression

Abstract

Abstract:

AIM: To examine the gender difference on response to sertraline, a selective serotonin reuptake inhibitor, and to imipramine, a tricyclic antidepressant, for chronic depression. METHODS: A total of 235 male and 400 female outpatients with DSM-III-R chronic major depression or bipolar depression (i.e., major depression superimposed on dysthymia) were randomly assigned to 12 weeks of double-blind treatment with sertraline or with imipramine after placebo washout.RESULTS:Women were significantly more likely to show a favorable response to sertraline than to imipramine, and men were significantly more likely to show a favorable response to imipramine than to sertraline. Gender and type of medication were also significantly related to dropout rates; women who were taking imipramine and men who were taking sertraline were more likely to withdraw from the study. Gender differences in time to response were seen with imipramine, with women responding significantly more slowly than men. Comparison of treatment response rates by menopausal status showed that premenopausal women responded significantly better to sertraline than to imipramine and that postmenopausal women had similar rates of response to the two medications. CONCLUSION: Men and women with chronic depression show differential responsivity and tolerability of SSRIs and tricyclic antidepressants. The differing response rates between the drug classes in women were observed primarily in pre-menopausal women. Thus, female sex hormones may enhance response to SSRIs or inhibit response to tricyclics. Both gender and menopausal status should be considered when choosing an appropriate antidepressant for a depressed patient.

Key words: gender differences, chronic depression, sertraline, imipramine

CLC Number:

R749.05

FANG Guodong, ZHANG Lihua, TANG Weiting. Effects of gender difference on response to sertraline and imipramine in patients with chronic depression[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(10): 1172-1179.

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