Clinical effect of converting antidepressant therapy from fluoxetine to sertraline.

The effect of replacing fluoxetine with sertraline at two dosage-conversion ratios was studied. Outpatients at a Veterans Affairs mental health clinic who were being treated with fluoxetine were randomly assigned to receive either 50 or 75 mg of sertraline hydrochloride for every 20 mg of fluoxetine (as the hydrochloride salt) or to continue to receive their current dosage of fluoxetine. The subjects were given the Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI) at baseline and were re-examined at one-month intervals for three months with the HDRS and BDI and the Clinical Global Impression of Change. Each patient was re-evaluated by the same blinded investigator. A total of 45 patients (42 men and 3 women) completed the study. The final overall response did not differ significantly among the three groups. There were also no significant differences among the groups in the proportions of patients with HDRS and BDI scores classified as improving, worsening, or not changing. Improvement was more common in patients receiving the higher dosage of sertraline. Few adverse effects were reported. Outpatients receiving fluoxetine were switched to sertraline therapy without a loss of control of depression and without substantial adverse effects.