ABSTRACT
This study was conducted to evaluate the effectiveness and acceptability of Tianeptine (T) versus Maprotiline (M) in the management of anxiodepressive disorders in menopausal and premenopausal women. Anxio-depressive women with a Montgomery Asberg Depression score (MADRS) > 20 and a Hamilton Anxiety score (HARS) > 15 were included in the study. T or M were the only psychotropes taken by the patients during the study. Eighty-three women were enrolled and given, by double blind assignment T 37.5 mg/day or M 75 mg/day (T n = 42; M n = 41). The effectiveness of therapy was assessed on D5, D15, D30 and D60 by the MADRS, HARS, CGI and CHESS scores; acceptability was assessed by the CHESS scale. To exclude placebo responders, the patients were treated with a placebo for 7 days prior to enrollment. A significant improvement in the MADRS score, compared with the previous score, remained until D60 for the T group and M group (p < 0.01). The improvement in the MADRS score was higher (p = 0.025) in the T group than in the M group. At D60, there was a statistically significant difference between T and M in favour of T (p = 0.04). Similar results were obtain with HARS and CGI (item 1). The incidence of side effect was significantly lower in the group treated with T than in the group treated with M. At any time point, there were more patients in the M group (p < 0.001) who complained of side effects than in the T group. The patients were divided into subgroups according to whether or not they were also receiving Hormone Replacement Therapy (HRT). The group taking HRT and T had a more significant reduction in HARS (p = 0.038) and CHESS (p = 0.015) than the group taking T only. T administrated as a single psychotropic agent showed an improvement in the symptoms of anxio-depression which were significantly more important than in the control group with better control of associated complaints.
