Department of Psychiatry, The Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NEI 4LP, UK
I have received speakers' fees from pharmaceutical companies that manufacture SSRIs.
Parker (2001) expertly reviews the evidence for efficacy and effectiveness of different classes of antidepressants. In particular, he addresses the issue of whether selective serotonin reuptake inhibitors (SSRIs) are less efficacious in melancholia; reviews effectiveness studies; examines why there is a discordance between efficacy studies and clinical observation; and reviews the implications of differential effectiveness.
An additional important area that should be considered is that of gender differences in treatment response to antidepressants. Recent evidence has arisen to suggest that women may have a better response to SSRIs and men a better response to tricyclic antidepressants (Kornstein et al, 2000). As depression is approximately twice as common in women than in men, gender differences of this nature are important and should be considered when reviewing this area. The reasons for this difference may be related to the effects of female sex hormones on serotonergic neurotransmission and in particular on the function of the 5-HT1A receptor (Young et al, 1993). The evidence for gender differences in treatment response to antidepressant is not definitive (Kornstein et al, 2001; Quitkin et al, 2001) and further studies are needed to fully establish the validity of this notion. However, there are potentially important implications, and in the future clinical management strategies may take account of gender differences in treatment response.
REFERENCES
Kornstein, S. G., Schatzberg, A. F., Thase, M. E., et
al (2000) Gender differences in treatment response to
sertraline versus imipramine in chronic depression. American
Journal of Psychiatry, 157,
1445-1452.
Kornstein, S. G., Schatzberg, A. F., Thase, M. E., et
al (2001) Dr Korstein and Colleagues reply (letter).
American Journal of Psychiatry,
158,
1532-1533.
Parker, G. (2001) New and
old antidepressants: all equal in the eyes of the lore?
British Journal of Psychiatry,
179, 95-96.
Quitkin, F. M., Stewart, J. W. & McGrath, P. J.
(2001) Gender differences in treatment response (letter).
American Journal of Psychiatry,
158,
1531-1532.
Young, A. H., Dow, R. C., Goodwin, G. M., et al (1993) The effects of adrenalectomy and ovariectomy on the behavioural and hypothermic responses of rats to 8-hydroxy-2(di-n-propylamino)tetralin (8-OH-DPAT). Neuropharmacology, 32, 653-657.[Medline]
HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Psychiatric Bulletin | Advances in Psychiatric Treatment | All RCPsych Journals |