Differential clinical effects of fluvoxamine by the effect of age in Japanese female major depressive patients

Hisashi Higuchi1, Kazuhiro Sato2, Shingo Naito3, Keizo Yoshida4, Hitoshi Takahashi5, et al1Department of Neuropsychiatry, St Marianna University School of Medicine, 2-16-1 Sugou, Miyamae-ku, Kawasaki City, Kanagawa 216-8511, Japan; 2Department of Psychiatry, Akita Kaiseikai Hospital, 1-7-5 Ushijima-nishi, Akita City, Akita 010-0063, Japan; 3Department of Neuropsychiatry, Akita City Hospital, 4-30 Kawamotomatsuoka-machi, Akita City, Akita 010-0933, Japan; 4Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi 466-8550, Japan; 5Department of Psychiatry, Tokyo Women’s Medical University School of Medicine, Kawada-cho, Shinjyukuku, Tokyo, 162-8666, Japan, et alAbstract: The effects of gender differences and age on the treatment response to fluvoxamine were investigated in major depressive Japanese patients. A total of 100 Japanese patients participated in this study. The daily dose of fluvoxamine was fixed to 100, 150 or 200 mg in the fourth week. This fixed dose was maintained until the end of the 6-week study. The patients were divided into 3 groups: younger females, older females, and males. Depressive symptoms were evaluated using the Montgomery and Åsberg Depression Rating Scale (MADRS) at pretreatment and at 1, 2, 4, and 6 weeks after the commencement of the study. Seven of the 100 patients were excluded, and the remaining 93 patients constituted the subjects (50 females, 43 males). The number of intent-to-treat responders and non-responders was 55 and 38, respectively. There was a significant difference in the changes in the time course of the MADRS score and changes in the MADRS scores at each evaluation point between the younger and older females. Younger females demonstrated a significantly better response than older females. The results suggest that fluvoxamine is more effective in younger female patients than in older female patients. Keywords: major depressive disorder, fluvoxamine, antidepressant response, menopausal status