A Double-Blind Comparison of Sertraline and Fluoxetine in Depressed Elderly Outpatients
J Clin Psychiatry 2000;61:559-568
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: There has been a paucity of
well-designed studies comparing selective serotonin reuptake
inhibitor (SSRI) medications in the treatment of depression in
the elderly. This multicenter study was designed to examine the
efficacy and safety of sertraline and fluoxetine in depressed
elderly outpatients. A secondary objective was to examine the
effects of SSRI treatment on quality of life and cognitive
Method: Two hundred thirty-six outpatients 60
years of age and older who met DSM-III-R criteria for major
depressive disorder received 1 week of single-blind placebo
before being randomly assigned to 12 weeks of double-blind,
parallel-group treatment with flexible daily doses of either
sertraline (range, 50-100 mg) or fluoxetine (range, 20-40 mg).
Primary efficacy measures consisted of the 24-item Hamilton
Rating Scale for Depression and Clinical Global Impressions scale
ratings. Secondary outcome assessments included clinician- and
patient-rated measures of depression symptoms and factors,
cognitive functioning, and quality of life, as well as plasma
drug concentrations, which were correlated with clinical
Results: Both drugs produced a similarly
positive response on the primary efficacy measures, with 12-week
responder rates of 73% for sertraline and 71% for fluoxetine.
Sertraline-treated patients showed statistically greater
cognitive improvement on several measures. Both drugs were safe
and well tolerated.
Conclusion: Data indicate that both drugs are
effective antidepressants for the treatment of depressed elderly
outpatients. Differences in cognitive performance effects deserve