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Effects of Nortriptyline and Paroxetine on Postural Sway in Depressed Elderly Patients

Received May 3, 2000; revised September 18, 2000; accepted January 22, 2001. From the Intervention Research Center for Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine. Address correspondence to Dr. Mamo, Western Psychiatric Institute & Clinic, 3811 O'Hara Street, Pittsburgh PA 15213. e-mail: mamodc{at}msx.upmc.edu

Tricyclic antidepressants (TCAs) have previously been found to be related to an increased incidence of falls in elderly persons. Recent pharmacoepidemiologic and nursing home studies have suggested that the risk of falls and fractures in elderly patients receiving selective serotonin reuptake inhibitors (SSRIs) is not different from that of patients receiving TCAs. The authors therefore evaluated postural sway in an older population of depressed patients randomly assigned to treatment with either nortriptyline or paroxetine and did not find any change in postural sway after 6 weeks' treatment with either antidepressant. Further studies with other SSRIs are needed.

Key Words: Depression • Nortriptyline • Paroxetine