Comparison of sertraline and nortriptyline in the treatment of major depressive disorder in late life

Citation
W. Bondareff et al., Comparison of sertraline and nortriptyline in the treatment of major depressive disorder in late life, AM J PSYCHI, 157(5), 2000, pp. 729-736
Citations number
37
Categorie Soggetti
Psychiatry,"Clinical Psycology & Psychiatry","Neurosciences & Behavoir
Journal title
AMERICAN JOURNAL OF PSYCHIATRY
ISSN journal
0002953X → ACNP
Volume
157
Issue
5
Year of publication
2000
Pages
729 - 736
Database
ISI
SICI code
0002-953X(200005)157:5<729:COSANI>2.0.ZU;2-T
Abstract
Objective: This study was designed to evaluate the comparative efficacy and safety of sertraline and nortriptyline for the treatment of major depressi ve disorder in older adults. Method: A double-blind, parallel group design was used to compare 210 outpa tients, 60 years of age and older, who met DSM-III-R criteria for major dep ressive episode and had a minimum Hamilton Depression Rating Scale score of 18. The patients were randomly assigned to 12 weeks of treatment with eith er sertraline (50-150 mg/day) or nortriptyline (25-100 mg/day). Results: The safety profiles of the two treatments were similar except that nortriptyline treatment was associated with a significant increase in puls e rate, whereas sertraline was associated with a nonsignificant decrease. E fficacy of both drugs was similar for both treatments at all time points, w ith 71.6% (N=53 of 74) of the sertraline-treated patients and 61.4% (N=43 o f 70) of the nortriptyline-treated patients achieving responder status by w eek 12. Time to response was also similar, with more than 75% of the improv ement in scores on the Hamilton depression scale having occurred by week 6. Secondary efficacy measures (posttreatment measures of cognitive function, memory and quality of life) revealed a significant advantage for sertralin e treatment. Conclusions: Primary efficacy measures showed sertraline and nortriptyline to be similarly effective. With secondary outcome measures there was consis tent evidence of an advantage for the sertraline-treated group. The clinica l impact of these measures on the longterm well-being of elderly depressed patients should be examined in a study of maintenance treatment.