title: Sertraline versus fluvoxamine in the treatment of elderly patients with major depression: a double-blind, randomized trial.
abstract: BACKGROUND
  Major depression is a common psychiatric disorder in the elderly population. The efficacy of tricyclic antidepressants is well established, and selective serotonin reuptake inhibitors appear to have a similar effectiveness along with advantages in terms of tolerability and safety. Given the lack of literature data regarding fluvoxamine in the treatment of depressed elderly patients, the aim of the present study was to compare its efficacy and tolerability with those of sertraline in a sample of elderly patients.
  
  
  METHODS
  Under double-blind conditions, 93 hospitalized patients older than 59 years, who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for a major depressive episode, were randomly assigned to receive sertraline (150 mg daily) or fluvoxamine (200 mg daily) for 7 weeks. The clinical response was defined as a reduction on the Hamilton Rating Scale for Depression score to 8 or below.
  
  
  RESULTS
  At study completion, the response rates were 55.6% (25/45) and 71.8% (28/39) for sertraline and fluvoxamine, respectively. No significant difference in final response rates was found between the 2 treatment groups (P = 0.12). A repeated-measures analysis of variance on Hamilton Rating Scale for Depression scores revealed a significantly different decrease of depressive symptoms between the 2 treatment groups, favoring fluvoxamine (P = 0.007). The overall safety profile of sertraline and fluvoxamine was favorable with no differences between the 2 drugs.
  
  
  CONCLUSIONS
  The results of this double-blind trial show that sertraline and fluvoxamine may be effective compounds in the treatment of elderly depression with the latter showing some advantage in terms of speed of response. These findings warrant further replication in placebo-controlled studies.
authors.affiliation: Department of Psychiatry, Vita-Salute University, San Raffaele Institute, Milan, Italy. rossini.david@hsr.it
authors.forename: David
authors.initials: D
authors.lastname: Rossini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serretti
authors.forename: Linda
authors.initials: L
authors.lastname: Franchini
authors.forename: Laura
authors.initials: L
authors.lastname: Mandelli
authors.forename: Enrico
authors.initials: E
authors.lastname: Smeraldi
authors.forename: Diana
authors.initials: D
authors.lastname: De Ronchi
authors.forename: Raffaella
authors.initials: R
authors.lastname: Zanardi
mesh_terms: D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D020280:Sertraline / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016666:Fluvoxamine; D020280:Sertraline