Two combined, multicenter double-blind studies of paroxetine and doxepin in geriatric patients with major depression

Depressive illness among the elderly is an important public health concern. However, treatment of the elderly may be complicated by age-related changes in physiology, general medical status, and susceptibility to side effects. There is therefore a need for improved treatment modalities for depressed...

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Bibliographic Details
Published inThe journal of clinical psychiatry Vol. 53 Suppl; p. 57
Main Authors Dunner, D L, Cohn, J B, Walshe, 3rd, T, Cohn, C K, Feighner, J P, Fieve, R R, Halikas, J P, Hartford, J T, Hearst, E D, Settle, Jr, E C
Format Journal Article
LanguageEnglish
Published United States 01.02.1992
Subjects
Age Factors
Aged
Ambulatory Care
Antidepressive Agents - therapeutic use
Depressive Disorder - drug therapy
Depressive Disorder - psychology
Double-Blind Method
Doxepin - therapeutic use
Female
Humans
Male
Middle Aged
Neurotransmitter Uptake Inhibitors - therapeutic use
Paroxetine
Patient Dropouts
Piperidines - therapeutic use
Psychiatric Status Rating Scales
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Summary:Depressive illness among the elderly is an important public health concern. However, treatment of the elderly may be complicated by age-related changes in physiology, general medical status, and susceptibility to side effects. There is therefore a need for improved treatment modalities for depressed elderly patients. Paroxetine is an antidepressant that acts through selective inhibition of serotonin reuptake. It lacks the anticholinergic and cardiovascular side effects of most first- and second-generation antidepressants. The authors present the combined data from two similarly designed comparisons of paroxetine and doxepin in outpatients over 60 years of age with major depression. The results show that paroxetine was an effective as doxepin in alleviating depression as measured on the Hamilton Rating Scale for Depression (HAM-D) total score, the Montgomery and Asberg Depression Rating Scale (MADRS), and the Hopkins Symptom Checklist (SCL) depression factor score. Paroxetine was significantly superior to doxepin on the Clinical Global Impressions (CGI) scale for severity of illness, the HAM-D retardation factor, and the HAM-D depressed mood item. Doxepin produced significantly more anticholinergic effects, sedation, and confusion. Paroxetine was associated with more reports of nausea and headache. These results suggest that paroxetine may be a valuable tool for the treatment of major depression in the elderly.
ISSN:0160-6689