Source: Radiology  |  Posted 8 years ago

The selective serotonin reuptake inhibitor sertraline was well tolerated and showed efficacy in the treatment of older adults with depression, according to findings from an 8-week, multicentre trial.

Study authors, led by Dr. Lon A. Schneider, University of Southern California in Los Angeles, believe this to be the first placebo-controlled trial of sertraline for older adults with depression.

The study randomised 747 outpatients aged 60 and older to sertraline of placebo. All patients had a diagnosis of major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV), and a Hamilton Depression (HAM-D) Rating Scale score of 18 or greater.

A total of 371 patients received sertraline, starting at 50 mg or 100 mg daily, and 376 patients received placebo.

HAM-D scores decreased a mean of 7.4 points in the sertraline group and 6.6 points in the placebo group. Clinical response, defined by the Clinical Global Impression scale, occurred in 45% of sertraline-treated patients and in 35% of placebo patients, a difference that was statistically significant.

Discontinuation of treatment due to adverse effects occurred in 8% of sertraline-treated patients and in 2% of placebo patients.

Dr. Schneider and associates say that the active treatment effect was greater toward the end of the 8-week trial, while improvement levelled off at about 6 weeks in the placebo group. "It may be that treatment of late-life depression, especially in patients with substantial medical co-morbidity, has a longer response latency than is observed in younger adults," they write.

The investigators speculate, "improvement in the sertraline group, and a greater drug-placebo difference, may have occurred if the trial had been longer."