A Twelve-Week, Double-Blind, Randomized Comparison of Nortriptyline and Paroxetine in Older Depressed Inpatients and Outpatients

Intervention Research Center for the Study of Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine; Geriatric Research, Education and Clinical Center, VA Pittsburgh Health Care System

Benoit H. Mulsant; Bruce G. Pollock; Robert Nebes; Mark D. Miller; Robert A. Sweet; Jackie Stack; Patricia R. Houck; Salem Bensasi; Sati Mazumdar; Charles F. Reynolds

2009

Scholarcy highlights

  • Intervention Research Center for the Study of Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine; Geriatric Research, Education and Clinical Center, VA Pittsburgh Health Care System
  • Selective serotonin reuptake inhibitors may be less efficacious than tricyclic antidepressants in the treatment of severe depression in older patients
  • The authors compared the 12-week clinical outcome of older depressed patients treated with nortriptyline or paroxetine in a double-blind randomized comparison in 116 psychiatric inpatients and outpatients who presented with a major depressive episode or melancholic depression
  • Discontinuation and response rates were compared in patients who began or who completed treatment
  • The discontinuation rate due to side effects was significantly higher with nortriptyline than with paroxetine
  • Paroxetine appears to be better tolerated than nortriptyline, the efficacy of these two drugs does not appear to differ in the acute treatment of older depressed patients, including hospitalized patients and those with melancholic features
  • This work was presented, in part, at the 2000 Annual Meeting of the American Psychiatric Association, Chicago, IL, May 2000, and the 40th New Clinical Drug Evaluation Unit Annual Meeting, Boca Raton, FL, June 2000

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