Pamelor, Zoloft relieve postpartum depression

Two antidepressants - Pamelor (also called nortriptyline) and Zoloft (also called sertraline) - work equally well for women suffering postpartum major depression, according to results of a randomized comparative trial.

It has been assumed that antidepressants that are effective for major depression outside of childbearing are also efficacious for postpartum major depression, note investigators in the Journal of Clinical Psychopharmacology.

"Our results support this assumption," write Dr. Katherine L. Wisner from the University of Pittsburgh Medical Center and colleagues.

They treated 109 women with postpartum major depression with Pamelor or Zoloft for 8 weeks with a 16-week "continuation phase" to assess durability of response.

Of the 109 women treated, 95 provided response data at 4 weeks, 83 at 8 weeks, and 29 completed at least 20 weeks of the study.

The number of women who responded or remitted and the time to response did not differ markedly between the two drugs at any of the study's time points, the investigators report.

At 4 weeks, 46 percent of Zoloft-treated women and 56 percent of Pamelor-treated women had responded and 27 percent and 30 percent, respectively, had remitted, "which is a reduction of symptoms consistent with full wellness," Wisner told Reuters Health.

"Remission should be the goal of depression treatment in general, but is particularly important in these mothers of young children," she added.

At 8 weeks, 56 percent of Zoloft-treated women and 69 percent of Pamelor-treated women had responded and 46 percent and 48 percent, respectively, had remitted.

Of those who remained on study until 20-24 weeks, 93 percent taking Zoloft and 100 percent taking Pamelor responded and 73 percent and 79 percent, respectively, remitted.

Psychological and social functioning improved similarly with both antidepressants and neither drug proved to be better than the other in treating aggressive obsessional thoughts.

"The total side effect burden of the two drugs was similar, although individual side effect profiles differed," Wisner said.

"Breastfeeding mothers were included, and the infants had no observable adverse effects, similar to other reports and reviews in the literature," she said.

SOURCE: Journal of Clinical Psychopharmacology August 2006.