Abstract
Objective
To assess the effectiveness and safety of fluoxetine and nortriptyline in major depressive disorders
Patients and Methods
This study was conducted in Sir Cowsee Jee Jehangie Institute of Psychiatry, Hyderabad in collaboration with Department of Pharmacology and Therapeutics Mohammad Medical College Mirpur Khas, from January 2009 to June 2009. Following a 1-week washout period, patients were randomly assigned to 12 weeks of parallel treatment with either fluoxetine (in a flexible daily dose of 20-80 mg) and nortriptyline (in a flexible daily dose of 25–100 mg) provided on a three times per day schedule. Clinical response was seen on weekly follow up basis.
Results
A total of 192 patients were included in this study. In the fluoxetine group, mean age was 38.2±8.8 years. In the Nortriptyline group, mean age was 39.5±11.6 years. At week-1, the gain in fluoxetine was - 55.4± 15.3 and in nortriptyline group it was - 35.4± 10.4 (P < 0.0001). Nausea and headache were common in nortriptyline 14.6% and 12.5% respectively and in Fuoxetine 4.2% and 4.2% respectively.
Conclusion
This study provides evidence in favor of efficacy and advantages of fluoxetine over Nortriptyline. Fluoxetine can be considered as first choice in pharmacological treatment of this disorder. Nausea and headache occurred more in nortriptyline than fluoxetine. (Rawal Med J 2011;36:38-40).

Key words: Depression, fluoxetine, nortriptyline, SSRI.