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Heuristic Comparison of Sertraline With Nortriptyline for the Treatment of Depression in Frail Elderly Patients

Received April 2, 1999; revised July 28, 1999; accepted October 4, 1999. From the Section of Geriatric Psychiatry, University of Pennsylvania, and the Philadelphia VAMC, Philadelphia, Pennsylvania. Address correspondence to Dr. Oslin, Section of Geriatric Psychiatry, University of Pennsylvania, 3600 Market St., Rm. 790, Philadelphia, PA 19104. e-mail: oslin{at}mail.med.upenn.edu

Studies have demonstrated that the selective serotonin reuptake inhibitor antidepressants have similar efficacy to other agents, such as tricyclic antidepressants. However, data are limited for direct comparisons with other antidepressants. The authors conducted a contemporaneous comparison of nursing home residents treated with open-label sertraline in doses up to 100 mg/day with nursing home residents treated in a double-blind randomized study of low vs. regular doses of nortriptyline. There were 97 patients enrolled in the study (28 treated with sertraline), with an average treatment duration of 55 days. There were no differences in the tolerability of sertraline vs. nortriptyline. However, in this group of frail older adults, sertraline was not as effective as nortriptyline for the treatment of depression.

Key Words: Nortriptyline • Sertraline • Depression • Frail Patients