[The study of the efficacy of fluoxetine versus tianeptine in the treatment of elderly depressed patients followed in general practice].
Depression in the elderly appears to be frequently poorly understood and underdiagnosed. The frequency of depressed illness in subjects over the age of 65 years is an important problem of health care. General practitioners are often in the first line of care. The objective of this trial was to compare the efficacy and safety of fluoxetine 20 mg/day to tianeptine 37.5 mg/day in elderly patients suffering from major depressive episode defined according to DSM III-R criteria, Newcastle Depression Scale < or = -20, without associated dementia Mini Mental Status (MMSE), treated by general practitioners in ten different french regions during 3 months. 237 patients were randomised, each patient had to be treated for 12 weeks and was reviewed 5 times during the trial. Patients had signed an informed consent. This trial was in favor of the superiority of fluoxetine compared to tianeptine. The main criterium, defined as the difference of the Montgomery and Asberg Depression Rating scale (MADRS) score between day 0 and day 84, was significantly different in favour of the fluoxetine group (intent to treat and per protocol analysis) (p = 0.019). The success rate at the end of the treatment (MADRS < or = 10) was significantly higher in the fluoxetine group (fluoxetine group: 48.4% vs tianeptine group: 28.1%) (p = 0.005). These results were confirmed by analysis of the other assessment criteria Geriatric Depression Scale (GDS) and Clinical Global Impression (CGI). During the study, the safety of the two treatments was comparable.
Guelfi
J D
JD
Université Paris XI, Hôpital Paul-Brousse, Villejuif.
Bouhassira
M
M
Bonett-Perrin
E
E
Lancrenon
S
S
D000368:Aged; D000553:Ambulatory Care; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011320:Primary Health Care; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013841:Thiazepines / Q000627:therapeutic use*; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors; D013841:Thiazepines; C050504:tianeptine
Etude de l'efficacité de la fluoxétine comparativement à celle de la tianeptine dans le traitement des patients âgés déprimés suivis en médecine générale.