The Effects of Fluoxetine on the Energy Level in Major Depressive Disorder: Multi-center Naturalistic Observational Study

Namkoong, Kee; Kim, Yun Jin; Lee, Pil Goo

Abstract

OBJECTIVE
A multi-center, open-labeled, prospective, observational study was conducted to evaluate the efficacy of fluoxetine on energy level over 8 weeks in a group of Korean patients with major depressive disorder. METHODS: Of 635 (Ed- to avoid having to say "Six hundred..") patients with major depressive disorder in 24 centers who were recruited to 8 weeks treatment with fluoxetine, 136 were terminated at initial session, leaving 499 patients to be included in the final analysis. They were predominantly female (59.5%), with a mean age of 45.7+/-15.9 years. At three visits to the clinic (weeks 0, 4 and 8), a record was made of Retardation Factor score of Hamilton Rating Scale for Depression (HD-RF), Lack of Energy score of Symptom Check List-90R (SCL-E), Energy score (QOL-E) and Fatigue score (QOL-F) of Quality of Life, and Visual Analogue Scale for Energy Level (VAS-E). RESULTS: The average dose of fluoxetine was 18.5+/-6.8mg/day for the first 4 weeks and 25.3+/-10.6 mg/day for the second 4 weeks. Of the patients, 85.4% in the first 4-week period and 86.8% in the second 4-week period took more than 85% of the prescribed medication. At least one of the concomitant anxiolytic drugs with fluoxetine was prescribed to 79.8% of the patients (alprazolam 47.9%, lorazepam 21.4%). The energy symptoms were significantly improved by fluoxetine over time, according to the analysis controlling the improvement effect of global depressive symptoms using repeated measures ANCOVA with the change of total HAM-D score as a covariate. Even comparing with the patients who took concomitant anti-anxiety medication, those who did not take concomitant anti-anxiety medication showed greater improvement of energy symptoms irrespective of the severity of baseline anxiety symptoms. CONCLUSION: These findings demonstrate that fluoxetine is effective in restoring the energy of patients with major depressive disorder. They also suggest that physicians should be careful in prescribing sedating antidepressants or concomitant anti-anxiety medication with fluoxetine for patients with major depressive disorder.