| Abstrakt: |
The antidepressant and anxiolytic efficacy of trazodone (100–200 mg daily), mianserin (60–120 mg daily) and diazepam (15–30 mg daily) was evaluated in ninety-three patients suffering from mild to moderate depression, with or without anxiety, over 6 weeks in a double-blind non-crossover general practice study. Efficacy was evaluated using the Hamilton Depression Rating Scale, Patient Self-Rating Visual Analogue scales, physician global assessments and the Zung Self-Rating Anxiety Scale.All three treatments significantly reduced symptoms of depression, as measured on the Hamilton Depression Rating Scale and the physician's assessment of Global Improvement. Trazodone was significantly superior to both mianserin and diazepam. As assessed using Visual Analogue Scales, trazodone was also shown to be significantly superior to diazepam in improving the patient's ability to concentrate and in reducing daytime tiredness. Although evidence of efficacy was found, there were no differences in activity between the treatment groups using the physician's assessment of Current Severity or on assessment of Therapeutic Effect. The treatments all caused a reduction in anxiety as assessed by the Zung Self-Rating Scale.The overall incidence of side-effects was similar between groups. For those side-effects considered to be significantly interfering with the patient's function, but not outweighing the therapeutic effect, a reduction of dosage was effective. Several patients complaining of drowsiness or lethargy as an unacceptable daytime side-effect were switched successfully from twice daily to night-time dosing. Significantly more patients with side-effects (outweighing therapeutic effect or in the presence of no improvement) were withdrawn from the mianserin group than from the trazodone or diazepam groups.Overall, the therapeutic efficacy in relation to the incidence of clinically significant side-effects, favoured trazodone for the treatment of general practice patients suffering from depression, with or without anxiety. |
