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ISSN 0016-3813 (Impreso)

2017, Número 6

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Gac Med Mex 2017; 153 (6)


Respuesta a antidepresivos serotoninérgicos y noradrenérgicos: estudio cruzado con fluoxetina y desipramina en pacientes con un primer episodio depresivo mayor

Ontiveros-Sánchez de la Barquera JA

Idioma: Español
Referencias bibliográficas: 31
Paginas: 688-694
Archivo PDF: 219.00 Kb.


RESUMEN

Antecedentes: Las tasas de respuesta a diferentes clases de antidepresivos ayudan a elaborar guías para la prescripción racional en farmacoterapia. Sin embargo, existen pocos estudios comparativos con antidepresivos inhibidores selectivos de la recaptación de serotonina o noradrenalina en la misma muestra de pacientes con depresión mayor. Método: Pacientes ambulatorios con un primer episodio depresivo mayor (DSM-III-R) que completaron 6 semanas de tratamiento en dos estudios a doble ciego aleatorizados con fluoxetina y desipramina que recibieron por 6 semanas de manera cruzada el otro fármaco antidepresivo. Como respuesta se consideró si el puntaje final de la escala Hamilton de depresión disminuyó un 50% o más desde la determinación basal. Resultados: No encontramos diferencias por tratamiento o secuencia. Diez de los 18 pacientes (55.5%) respondieron a fluoxetina y desipramina, tres(16.6%) fueron resistentes para fluoxetina y tres (16.6%) para Desipramina, y dos (11.1%) para ambos fármacos. Discusión: Nuestro estudio sugiere que, en pacientes ambulatorios con un primer episodio depresivo, la fluoxetina y la desipramina son igualmente eficaces. En los pacientes que no respondieron a uno de los fármacos estudiados, el otro tratamiento fue eficaz; esta maniobra de tratamiento debe ser considerada en estos pacientes.


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