Antidepressant efficacy of sertraline and imipramine for the treatment of major depression in elderly outpatients

Sao Paulo Medical Journal

Orestes Vicente Forlenza²  Alberto Stoppe Júnior¹  Edson Shiguemi Hirata¹  Rita Cecília Reis Ferreira¹ 

[1] ,Universidade de São Paulo Faculdade de Medicina Hospital das ClínicasSão Paulo,Brazil

关键词: Depression;    Elderly;    Antidepressant drugs;    Tricyclics;    Sertraline;    SSRI's;    Depressão;    Idoso;    Antidepressivos;    Tricíclicos;    Sertralina;    ISRS's;   

DOI  :  10.1590/S1516-31802000000400005

来源: SciELO

【 摘 要 】

CONTEXT: Most double-blind studies of efficacy and tolerability of sertraline as compared to tricyclics in the treatment of late-life major depression have used amitriptyline as a standard, leading to the inevitable conclusion that the former drug is better tolerated than the latter, with both being equally efficacious. OBJECTIVE: To compare the antidepressant efficacy and tolerability of sertraline (50 mg/day) and imipramine (150 mg/day) in the first 6 weeks of the treatment of major depression in the elderly. DESIGN: A randomized double-blind parallel study with 6 weeks of follow-up. SETTING: The psychogeriatric clinic at the Institute of Psychiatry, Hospital das Clínicas, Faculty of Medicine of the University of São Paulo. PARTICIPANTS: 55 severe and moderately depressed non-demented outpatients aged 60 years or more. INTERVENTION: Patients were assigned to sertraline 50 mg/day or imipramine 150 mg/day. MAIN MEASUREMENTS: CAMDEX interview. Psychiatric diagnosis followed the guidelines for "Major Depressive Episode" according to DSM-IV criteria. Severity of symptoms was evaluated using the "CGI" and "MADRS" scales. Cognitive state was assessed using the Mini-Mental State Examination. Side effects were assessed using the "Safetee-Up" schedule. RESULTS: Both groups had a significant decrease in depressive symptoms according to the MADRS scores after 6 weeks of treatment (P = 0.01). No significant differences between groups were detected regarding treatment outcome (t = 0.4; P = 0.7). Although the dropout rate was greater in the imipramine group, the overall tolerability among patients who completed the 6-week trial was similar in both test groups. CONCLUSIONS: Both sertraline and imipramine exhibited good efficacy and an acceptable side-effect profile for elderly depressed patients after 6 weeks of antidepressant treatment.

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