Major Depressive Disorder
Conditions
Brief summary
The purpose of this study is to evaluate the short-term efficacy and safety of Fluoxetine in Japanese adult participants with Major Depressive Disorder (MDD).
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Outpatient Japanese participants diagnosed with MDD * Diagnosis of moderate or greater severity of MDD * Agree to abstain from sexual activity or to use a reliable method of birth control * Judged to be reliable (agree to keep appointments for clinic visits and to undergo all tests and examinations required by the protocol)
Exclusion criteria
* Have previously been exposed to fluoxetine (LY110140) for any indication in the past * Significant suicidal risk * Have a current or previous diagnosis of bipolar disorder, psychotic depression, schizophrenia or other psychotic disorder, anorexia, bulimia, obsessive compulsive disorder, or post-traumatic stress disorder * Have a history of substance abuse or dependence within the past 6 months, excluding caffeine and nicotine * Have initiated, stopped, or changed the type or intensity of psychotherapy within 6 weeks * Have a history of electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), or vagus nerve stimulation (VNS) within 1 year * Have had treatment with a Monoamine oxidase inhibitor (MAOI) within 14 days * Need to use thioridazine or pimozide during the study * Have previously enrolled, completed, or withdrawn from this study * Have a positive urine drug screen for drugs with abuse potential * Female participants who are either pregnant, nursing, or have recently given birth, or male participants who are planning for their partners to be or become pregnant * Have a history of seizure disorder * Have frequent or severe allergic reactions to multiple medications * Have a serious or unstable medical illness or condition, or psychological condition * Participants deemed ineligible by the investigator or sub-investigator for other reasons
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total Score | Baseline, 6 weeks | HAMD21 is a 21-item assessment used to measure depression severity. Items were rated on a scale from 0 (symptoms not present) to a maximum of 2 to 4 (symptom extremely severe) for a total score ranging from 0 (not at all depressed) to 64 (severely depressed). Least squares (LS) means were calculated using mixed-model repeated measures (MMRM) adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline HAMD21 total score. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Achieving a Response at 6-Week Endpoint | up to 6 weeks | The percentage of participants achieving a response (defined as a ≥50% improvement from baseline on the HAMD21 total score) was calculated by dividing the number of participants achieving a response at last observation by the total number of participants at risk, multiplied by 100. |
| Percentage of Participants Achieving a Remission at 6-Week Endpoint | up to 6 weeks | The percentage of participants achieving a remission (defined as a HAMD21 total score ≤7) was calculated by dividing the number of participants achieving a remission at last observation by the total number of participants at risk, multiplied by 100. |
| Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Baseline, 6 weeks | HAMD17 total scores and subscale scores from the HAMD21 are presented. HAMD17 is a 17-item assessment of depression severity (total scores range from 0-52). The Maier subscale (Items 1, 2, 7-10) represents the core symptoms of depression (0-24). Anxiety/Somatization subscale (Items 10-13, 15, 17) evaluates severity of psychic and somatic manifestations of anxiety as well as agitation (0-18). Retardation/Somatization subscale (Items 1, 7, 8, 14) evaluates dysfunction in mood, work, and sexual activity, as well as overall motor retardation (0-14). Sleep subscale (Items 4-6) assesses insomnia (0-6). Individual item scores may range from 0-4 or 0-2. Higher scores indicate more severe symptoms. LS means were calculated using MMRM adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline score. |
| Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Baseline, up to 6 weeks | SDS was completed by the participant and was used to assess the effect of the participant's symptoms on their work/school (Item 1), social life/leisure activities (Item 2), and family life/home responsibilities (Item 3). Each item was measured on a 0 (not at all) to 10 (extremely) point scale with higher values indicating greater disruption. Total score was the sum of the 3 items and ranged from 0 to 30 with higher values indicating greater disruption in the participant's work/social/family life. LS means were calculated using analysis of covariance (ANCOVA) adjusting for treatment, pooled investigative site, and baseline SDS score. |
| Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS) | Baseline through 6 weeks | C-SSRS captures occurrence, severity, and frequency of suicide-related thoughts and behaviors. Suicidal behavior is defined as a yes answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide. Suicidal ideation is defined as a yes answer to any one of 5 suicidal ideation questions: wish to be dead, and 4 different categories of active suicidal ideation. |
| Mean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) Scale | Baseline, 6 weeks | CGI-S measures severity of illness at the time of assessment with scores ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill participants). LS means were calculated using MMRM adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline CGI-S score. |
Countries
Japan
Participant flow
Pre-assignment details
This study consisted of 3 periods: a single-blind screening period (1 week of placebo), a double-blind short-term treatment period (1 week of placebo followed by randomization in a 2:1:3 fashion to 20 milligrams \[mg\] fluoxetine, 40 mg fluoxetine, or placebo, respectively, for 6 weeks), and a single-blind discontinuation period (2 weeks of placebo).
Participants by arm
| Arm | Count |
|---|---|
| 20 mg Fluoxetine 20 mg fluoxetine (capsules) administered orally, once daily, for 6 weeks | 168 |
| 40 mg Fluoxetine 40 mg fluoxetine (capsules) administered orally, once daily, for 6 weeks | 83 |
| Placebo Placebo (capsules) administered orally, once daily, for 6 weeks | 259 |
| Total | 510 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Discontinuation Period | Adverse Event | 1 | 0 | 0 |
| Discontinuation Period | Lost to Follow-up | 0 | 1 | 0 |
| Discontinuation Period | Physician Decision | 1 | 0 | 0 |
| Treatment Period | Adverse Event | 8 | 4 | 3 |
| Treatment Period | Lack of Efficacy | 1 | 1 | 2 |
| Treatment Period | Lost to Follow-up | 2 | 2 | 1 |
| Treatment Period | Physician Decision | 1 | 0 | 4 |
| Treatment Period | Protocol Violation | 1 | 0 | 0 |
| Treatment Period | Sponsor Decision | 1 | 0 | 0 |
| Treatment Period | Withdrawal by Subject | 1 | 0 | 4 |
Baseline characteristics
| Characteristic | 20 mg Fluoxetine | Total | Placebo | 40 mg Fluoxetine |
|---|---|---|---|---|
| Age, Continuous | 40.05 years STANDARD_DEVIATION 11.19 | 39.20 years STANDARD_DEVIATION 11.33 | 38.54 years STANDARD_DEVIATION 11.65 | 39.58 years STANDARD_DEVIATION 10.56 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 168 Participants | 510 Participants | 259 Participants | 83 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 168 Participants | 510 Participants | 259 Participants | 83 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Region of Enrollment Japan | 168 participants | 510 participants | 259 participants | 83 participants |
| Sex: Female, Male Female | 83 Participants | 245 Participants | 129 Participants | 33 Participants |
| Sex: Female, Male Male | 85 Participants | 265 Participants | 130 Participants | 50 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk |
|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 75 / 259 | 49 / 168 | 30 / 83 | 5 / 145 | 5 / 87 | 2 / 38 |
| serious Total, serious adverse events | 2 / 259 | 0 / 168 | 0 / 83 | 1 / 145 | 0 / 87 | 0 / 38 |
Outcome results
Mean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total Score
HAMD21 is a 21-item assessment used to measure depression severity. Items were rated on a scale from 0 (symptoms not present) to a maximum of 2 to 4 (symptom extremely severe) for a total score ranging from 0 (not at all depressed) to 64 (severely depressed). Least squares (LS) means were calculated using mixed-model repeated measures (MMRM) adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline HAMD21 total score.
Time frame: Baseline, 6 weeks
Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline HAMD21 total score during the Treatment Period.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total Score | -6.18 units on a scale | Standard Error 0.57 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total Score | -6.25 units on a scale | Standard Error 0.77 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total Score | -6.91 units on a scale | Standard Error 0.49 |
Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores
SDS was completed by the participant and was used to assess the effect of the participant's symptoms on their work/school (Item 1), social life/leisure activities (Item 2), and family life/home responsibilities (Item 3). Each item was measured on a 0 (not at all) to 10 (extremely) point scale with higher values indicating greater disruption. Total score was the sum of the 3 items and ranged from 0 to 30 with higher values indicating greater disruption in the participant's work/social/family life. LS means were calculated using analysis of covariance (ANCOVA) adjusting for treatment, pooled investigative site, and baseline SDS score.
Time frame: Baseline, up to 6 weeks
Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline SDS score during the Treatment Period. Missing endpoints were imputed with the last observation carried forward (LOCF) method, using only postbaseline data.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Total score (n=167, 81, 259) | -1.76 units on a scale | Standard Error 0.59 |
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Work/School subscale score (n=143, 64, 226) | -0.79 units on a scale | Standard Error 0.27 |
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Social/Leisure subscale score (n=167, 81, 259) | -0.66 units on a scale | Standard Error 0.23 |
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Family/Home subscale score (n=167, 81, 259) | -0.47 units on a scale | Standard Error 0.21 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Family/Home subscale score (n=167, 81, 259) | -0.30 units on a scale | Standard Error 0.28 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Total score (n=167, 81, 259) | -1.55 units on a scale | Standard Error 0.78 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Social/Leisure subscale score (n=167, 81, 259) | -0.81 units on a scale | Standard Error 0.3 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Work/School subscale score (n=143, 64, 226) | -0.34 units on a scale | Standard Error 0.36 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Family/Home subscale score (n=167, 81, 259) | -0.41 units on a scale | Standard Error 0.19 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Work/School subscale score (n=143, 64, 226) | -0.88 units on a scale | Standard Error 0.24 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Social/Leisure subscale score (n=167, 81, 259) | -0.70 units on a scale | Standard Error 0.21 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores | Total score (n=167, 81, 259) | -1.99 units on a scale | Standard Error 0.53 |
Mean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) Scale
CGI-S measures severity of illness at the time of assessment with scores ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill participants). LS means were calculated using MMRM adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline CGI-S score.
Time frame: Baseline, 6 weeks
Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline CGI-S score during the Treatment Period.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) Scale | -0.69 units on a scale | Standard Error 0.08 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) Scale | -0.67 units on a scale | Standard Error 0.11 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) Scale | -0.81 units on a scale | Standard Error 0.07 |
Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores
HAMD17 total scores and subscale scores from the HAMD21 are presented. HAMD17 is a 17-item assessment of depression severity (total scores range from 0-52). The Maier subscale (Items 1, 2, 7-10) represents the core symptoms of depression (0-24). Anxiety/Somatization subscale (Items 10-13, 15, 17) evaluates severity of psychic and somatic manifestations of anxiety as well as agitation (0-18). Retardation/Somatization subscale (Items 1, 7, 8, 14) evaluates dysfunction in mood, work, and sexual activity, as well as overall motor retardation (0-14). Sleep subscale (Items 4-6) assesses insomnia (0-6). Individual item scores may range from 0-4 or 0-2. Higher scores indicate more severe symptoms. LS means were calculated using MMRM adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline score.
Time frame: Baseline, 6 weeks
Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline HAMD21 subscale score during the Treatment Period.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Retardation/Somatization subscale score | -2.00 units on a scale | Standard Error 0.2 |
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Anxiety/Somatization subscale score | -2.04 units on a scale | Standard Error 0.21 |
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | HAMD17 total score | -5.59 units on a scale | Standard Error 0.53 |
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Maier subscale score | -3.35 units on a scale | Standard Error 0.3 |
| 20 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Sleep subscale score | -0.83 units on a scale | Standard Error 0.15 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Anxiety/Somatization subscale score | -1.84 units on a scale | Standard Error 0.28 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | HAMD17 total score | -5.61 units on a scale | Standard Error 0.71 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Maier subscale score | -3.39 units on a scale | Standard Error 0.4 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Retardation/Somatization subscale score | -2.21 units on a scale | Standard Error 0.27 |
| 40 mg Fluoxetine | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Sleep subscale score | -0.81 units on a scale | Standard Error 0.2 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Sleep subscale score | -1.10 units on a scale | Standard Error 0.13 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Retardation/Somatization subscale score | -2.23 units on a scale | Standard Error 0.17 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | HAMD17 total score | -6.27 units on a scale | Standard Error 0.45 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Anxiety/Somatization subscale score | -2.06 units on a scale | Standard Error 0.18 |
| Placebo | Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores | Maier subscale score | -3.30 units on a scale | Standard Error 0.26 |
Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS)
C-SSRS captures occurrence, severity, and frequency of suicide-related thoughts and behaviors. Suicidal behavior is defined as a yes answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide. Suicidal ideation is defined as a yes answer to any one of 5 suicidal ideation questions: wish to be dead, and 4 different categories of active suicidal ideation.
Time frame: Baseline through 6 weeks
Population: Randomized participants who received at least 1 dose of study drug with at least 1 post-baseline C-SSRS score during the Treatment Period.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| 20 mg Fluoxetine | Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS) | Suicidal behavior | 0 participants |
| 20 mg Fluoxetine | Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS) | Suicidal ideation | 5 participants |
| 40 mg Fluoxetine | Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS) | Suicidal behavior | 0 participants |
| 40 mg Fluoxetine | Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS) | Suicidal ideation | 6 participants |
| Placebo | Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS) | Suicidal behavior | 1 participants |
| Placebo | Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS) | Suicidal ideation | 8 participants |
Percentage of Participants Achieving a Remission at 6-Week Endpoint
The percentage of participants achieving a remission (defined as a HAMD21 total score ≤7) was calculated by dividing the number of participants achieving a remission at last observation by the total number of participants at risk, multiplied by 100.
Time frame: up to 6 weeks
Population: Randomized participants who received at least 1 dose of study drug with a baseline (which had not achieved remission threshold criteria) and had at least 1 post-baseline HAMD21 total score during the Treatment Period. Missing endpoints were imputed with the last observation carried forward (LOCF) method, using only post-baseline data.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 20 mg Fluoxetine | Percentage of Participants Achieving a Remission at 6-Week Endpoint | 9.5 percentage of participants |
| 40 mg Fluoxetine | Percentage of Participants Achieving a Remission at 6-Week Endpoint | 9.6 percentage of participants |
| Placebo | Percentage of Participants Achieving a Remission at 6-Week Endpoint | 15.1 percentage of participants |
Percentage of Participants Achieving a Response at 6-Week Endpoint
The percentage of participants achieving a response (defined as a ≥50% improvement from baseline on the HAMD21 total score) was calculated by dividing the number of participants achieving a response at last observation by the total number of participants at risk, multiplied by 100.
Time frame: up to 6 weeks
Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline HAMD21 total score during the Treatment Period. Missing endpoints were imputed with the last observation carried forward (LOCF) method, using only post-baseline data.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 20 mg Fluoxetine | Percentage of Participants Achieving a Response at 6-Week Endpoint | 23.8 percentage of participants |
| 40 mg Fluoxetine | Percentage of Participants Achieving a Response at 6-Week Endpoint | 18.1 percentage of participants |
| Placebo | Percentage of Participants Achieving a Response at 6-Week Endpoint | 27.8 percentage of participants |