Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
Copyright 1999 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.1999
In Reply: We disagree with the statement by
Drs Baldessarini and Viguera that the maintenance effects of sertraline in
our study represent only "moderate sparing of relapse." A 4-fold reduction
in depression recurrence (23% with placebo vs 6% with sertraline) represents
a substantial reduction in risk. Further, we are not as surprised as Baldessarini
and Viguera at the relatively low relapse rate observed when switching to
placebo in our study, which probably resulted from several factors: (1) patients
randomized to sertraline or placebo were a compliant and responsive subset
(38%) of the original patient sample, (2) placebo treatment was not a "no
treatment" condition since study participation necessarily involved a high
degree of nonspecific supportive therapy, and (3) chronicity may constitute
less of an immediate relapse risk than a high number of prior episodes.
Keller MB, Kocsis JH, Thase ME, Gelenberg AJ, Rush AJ, Koran L, Schatzberg A, Russell J, Hirschfeld R, Klein D, McCullough JP, Kornstein S, Fawcett JA, LaVange L, Harrison W, . Relapse of Depressive Symptoms After Discontinuing Sertraline—Reply. JAMA. 1999;282(4):323-324. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-4-jbk0728