Antidepressant efficacy and safety of low-dose sertraline and standard-dose imipramine for the treatment of depression in older adults: Results from a double-blind, randomized, controlled clinical trial

This study compared the efficacy and tolerability of 150 mg/day imipramine and 50 mg/day sertraline for the treatment of a major depressive episode (D SM-IV) in older adults (N = 55) in an 8-week, randomized, double-blind, con trolled clinical trial. Intention-to-treat analysis (last observation carri ed forwards) showed a reduction of 50% or more on the baseline scores of th e Montgomery-Angstrom sberg Rating Scale (MADRS) in 60.7% and 55.6% of pati ents receiving imipramine and sertraline, respectively (p =.698). Full remi ssion of symptoms (MADRS < 9) was observed in 50.0% and 51.8% of patients, respectively (p = .891). Side effects were more frequent among patients tre ated with imipramine (86.7%) than among patients treated with sertraline (4 2.1%) (p =.008). Dropout rates were high in both groups (46.4% and 29.6% re spectively, p =.200). These results indicate that imipramine and sertraline are equally effective for the treatment of major depression in later life, although adverse reactions are more frequent among subjects treated with i mipramine than with sertraline.