The largest study with positive findings,

a double-blind clinical trial comparing response rates to sertraline or imipramine after 12 weeks of treatment in 635 depressed patients, found women responded better to sertraline, while men responded better to imipramine. Researchers also noted a. sex effect in dropout, rates: men were more likely to withdraw from the study if randomly assigned sertraline, while women were more likely to drop out if given imipramine.157 Similarly, while a study of 195 depressed outpatients comparing response to fluoxetine versus nortriptyline found no sex difference Inhibitors,research,lifescience,medical in study completers, an intention-to-treat analysis revealed that fluoxetine treatment led to superior results Inhibitors,research,lifescience,medical for women (due to lower drop-out, rates), while men were significantly more likely to drop out of the study if randomly assigned to fluoxetine.158 A third paper presented a retrospective metaanalysis of 11 double-blind studies, which compared the efficacy of fluoxetine with that of a variety of TCAs (amitriptyline,

desipramine, doxepin, imipramine, or nortriptyline) in female patients. The authors found no significant difference in the effectiveness of TCAs and fluoxetine in the treatment of depressed women, but, more women completed the trial if assigned to fluoxetine.159 Finally, in a double-blind study comparing the response to imipramine Inhibitors,research,lifescience,medical versus sertraline and permitting nonresponders to switch treatment groups after 12 weeks, researchers found women tended to be overrcprescnted in Inhibitors,research,lifescience,medical the group that switched from imipramine to sertraline.160 From

these studies, it. appears that women are more likely to discontinue treatment if given a. TCA, due to either increased side effects or lack of response Inhibitors,research,lifescience,medical or both, and are more likely to continue treatment, if given an SSRI. Support, for the existence of sex-related differences in response to antidepressants is found in several studies showing that younger women (a presumed proxy for reproductive status) respond better to fluoxetine, while older women respond better to imipramine or maprotiline.150,153,157,161,162 Nonetheless, substantial evidence exists for the absence of sex-differences in antidepressant response,163 including two large meta-analyses,164,165 the most recent of which found no differences between men, premenopausal women, and postmenopausal Terminal deoxynucleotidyl transferase women in their response to TCAs and fluoxetine.165 Despite these impressive negative findings, it. is ABT888 Nonetheless striking how rarely we see data in the opposite direction, ie, superior response to fluoxetine in men or to TCAs in (younger) women. While subject, to limited study, it. appears that women have a more favorable response to monoamine oxidase inhibitors (MAOIs). MAOIs were noted to more effectively treat, atypical depression in women than in men.