A randomised, double-blind comparison of the efficacy and safety of citalopram compared to mianserin in elderly, depressed patients with or without mild to moderate dementia

✍ Scribed by Ingvar Karlsson; Jan Godderis; Carlos Augusto De Mendonça Lima; Harald Nygaard; Margarete Simányi; Maarja Taal; Mirjam Eglin

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 327 KB
• Volume: 15
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/(sici)1099-1166(200004)15:4<295::aid-gps105>3.0.co;2-c

✦ Synopsis

Depression is the most common psychiatric disorder among the elderly and in old age may interact with emotional and cognitive functioning. Depression in old age has been shown to be associated with degenerative changes in the brain. It is, therefore, important that in this patient population antidepressants with a favourable tolerability pro®le, such as the selective serotonin reuptake inhibitors (SSRIs), are examined for both antidepressant ecacy and eect on cognitive function and emotional impairment. This randomised, double-blind study compared the ecacy and tolerability of citalopram and mianserin in 336 elderly, depressed patients with or without dementia. Patients received either citalopram 20±40 mg/day or mianserin 30±60 mg/day for 12 weeks. The treatments were equivalent with respect to change in Montgomery±A Ê sberg Depression Rating Scale (MADRS) total score; patients in both treatment groups responded well. Patients with dementia showed a smaller decrease in total MADRS score than patients without dementia. Both treatments were well tolerated with a relatively low incidence of adverse events. Fatigue and somnolence were more frequent with mianserin, while insomnia was more frequent with citalopram. Overall, this study showed that the two treatments were equivalent in ecacy, and that citalopram is an eective, well-tolerated and non-sedative treatment for elderly depressed patients with or without dementia.