Double-blind, multicenter comparison of sertraline and amitriptyline in elderly depressed patients.
Two hundred forty-one elderly depressed patients entered the 8-week, double-blind phase of this parallel-group, multicenter study; 161 patients were randomized to receive sertraline (50-200 mg/day) and 80 were randomized to receive amitriptyline (50-150 mg/day). Among evaluable patients, there were no statistically significant differences between treatments in any of the primary efficacy variables: change in total Hamilton Rating Scale for Depression (HAM-D) score (17 items), percentage change in HAM-D score, change in HAM-D Item 1, change in Clinical Global Impressions (CGI) Severity score, change in the Depression Factor of the 56-item Hopkins Symptom Checklist, and the CGI Improvement score at the last visit. Similar results were obtained using data from all patients (intention-to-treat analysis), except that amitriptyline was superior in HAM-D Total score (p = .044). The two drugs produced a similar degree of response: on the basis of the HAM-D criterion, 69.4% of sertraline patients and 62.5% of amitriptyline patients responded, and, on the basis of CGI criterion, 79.5% of sertraline and 73.4% of amitriptyline patients responded. Twenty-eight percent of the sertraline patients withdrew from the study because of a treatment-related side effect and 2.5% (4) because of a laboratory abnormality. In comparison, 35% of the amitriptyline patients withdrew because of treatment-related side effects. Sertraline was associated with a statistically lower frequency of somnolence, dry mouth, constipation, ataxia, and pain and a higher frequency of nausea, anorexia, diarrhea/loose stools, and insomnia; thus, anticholinergic effects were less common and gastrointestinal effects were more common with sertraline than with amitriptyline.(ABSTRACT TRUNCATED AT 250 WORDS)
Cohn
C K
CK
Hauser Clinic, Department of Psychiatry, University of Texas, Houston 77074.
Shrivastava
R
R
Mendels
J
J
Cohn
J B
JB
Fabre
L F
LF
Claghorn
J L
JL
Dessain
E C
EC
Itil
T M
TM
Lautin
A
A
D015057:1-Naphthylamine / Q000031:analogs & derivatives* / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000639:Amitriptyline / Q000494:pharmacology / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011674:Pulse / Q000187:drug effects; D012702:Serotonin Antagonists / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D020280:Sertraline
D012702:Serotonin Antagonists; D000639:Amitriptyline; D015057:1-Naphthylamine; D020280:Sertraline