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Sertraline Is Effective in Treatment of Depression of Older Adults
A DGReview of :"An 8-week multicenter, parallel-group, double-blind, placebo-controlled study of sertraline in elderly outpatients with major depression"
American Journal of Psychiatry
07/21/2003
By Martha Kerr
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."
Am J Psychiatry 2003;160:7:1277-1285.
"An 8-week multicenter, parallel-group, double-blind, placebo-controlled study of sertraline in elderly outpatients with major depression"
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