2007 issue 4


Volume 23, issue 4

Original article

The relation between stressful live events and effi cacy of escitalopram and nortriptyline treatment in depressed patients

Aleksandra Rajewska-Rager1, Paweł Kapelski1, Anna Leszczyńska-Rodziewicz1, Magdalena Kaczmarkiewicz-Fass1, Joanna Hauser1,2
1. Klinika Psychiatrii Dorosłych Uniwersytetu Medycznego w Poznaniu
2. Pracownia Genetyki Psychiatrycznej Katedry Psychiatrii Uniwersytetu Medycznego w Poznaniu
Farmakoterapia w Psychiatrii i Neurologii, 2007, 4, 181–185
Keywords: depression, stressful live events, drug response, escitalopram, nortriptyline


Aim: The recent studies suggest a signifi cant role of stressful live events (sLE) in the pathogenesis of depressive symptoms. The aim of this study was to analyze antidepressants treatment effi cacy in correlation of presence and severity of stressful live events occurring 6 month prior to depression episode.
Material and methods: We analyzed 95 patients in the age between 19-68 years old (mean 38), suffering from depressive disorder of at least moderate severity, diagnosed according to DSM-IV and ICD-10 criteria by two different psychiatrists. Patients were randomized to one of the 2 different treatment regimes, and were observed during 8 weeks. The treatment recommended dosage ranges were: escitalopram 10-20 mg/day (n=55) and nortriptyline 75-150mg/day (n=40). The Hamilton Rating Scale (HAMD-17) was used for the assessment of the severity of depressive symptoms. Response for treatment was defi ned as ≥ 50% score reduction from baseline on HAMD17. Based on BLEQ questionnaire two different patient subgroups was distinguished: patients with mild stressful live events (sLE ≤ 6) and those with more severe sLE (sLE ≥ 6). Statistical analysis was performed using Statistica 7.1 program.
Results: The analysis showed no signifi cant differences were observed beetwen effi cacy of escitalopram and nortryptyline in both subgroups: sLE ≤ 6 (p=0,106) and sLE ≥ 6 (p= 0,02).

Address for correspondence:
Aleksandra Rajewska-Rager
Klinika Psychiatrii Dorosłych UM im. K. Marcinkowskiego w Poznaniu
ul. Szpitalna 27/33, 60-572 Poznań
tel. (0 61) 849 15 31, fax. (0 61) 848 03 92
e-mail: aleksandra.rajewska@interia.pl