title: Double-blind, multicenter comparison of sertraline and amitriptyline in elderly depressed patients.
abstract: 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)
authors: Hauser Clinic, Department of Psychiatry, University of Texas, Houston 77074.
authors: C K
authors: CK
authors: Cohn
authors: R
authors: R
authors: Shrivastava
authors: J
authors: J
authors: Mendels
authors: J B
authors: JB
authors: Cohn
authors: L F
authors: LF
authors: Fabre
authors: J L
authors: JL
authors: Claghorn
authors: E C
authors: EC
authors: Dessain
authors: T M
authors: TM
authors: Itil
authors: A
authors: A
authors: Lautin
mesh_terms: 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
chemical_list: D012702:Serotonin Antagonists; D000639:Amitriptyline; D015057:1-Naphthylamine; D020280:Sertraline