Citalopram versus nortriptyline in late-life depression: a 12-week randomized single-blind study

Objective: The aim of this single-blind study was to examine the efficacy a nd tolerability of citalopram compared to nortriptyline in moderate to seve re major depressive patients aged 60 years or over. Method: In- and out-patients (N = 58) with unipolar major depression were r andomized to 12-week flexible dose treatment with nortriptyline or citalopr am. Results: No significant differences between the number of drop-outs in eith er group were observed, but the autonomic side-effects were significantly h igher for nortriptyline than for citalopram. A significantly higher remissi on rate to nortriptyline than to citalopram was demonstrated, particularly if severe patients (endogenous or psychotic patients) were assessed. Conclusion: The remission rate to a therapeutic plasma level of nortriptyli ne appears to be higher than the remission rate to a standard dose of cital opram in a group of elderly major depressed patients, especially those with endogenous or psychotic features. On the other hand, citalopram appears to be better tolerated.