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Weight Change in Older Depressed Patients During Acute Pharmacotherapy With Paroxetine and Nortriptyline

A Double-Blind Randomized Trial

Received June 28, 1999; revised August 20, 1999; accepted October 4, 1999. From the Intervention Research Center for Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. Address correspondence to Dr. Reynolds, Western Psychiatric Institute and Clinic, E1135, 3811 O'Hara Street, Pittsburgh, PA 15213. e-mail: ReynoldsCF{at}msx.upmc.edu

The authors examined weight change in 32 elderly patients treated for 12 weeks with either nortriptyline or paroxetine during acute-phase pharmacotherapy. Random assignment to treatment and double-blind assessment of weight change were performed, including ascertainment of premorbid (i.e., pre-depression) weight. Pretreatment severity of depression was correlated with weight loss during the depressive episode and depression-related weight loss, in turn, correlated with weight regained during antidepressant treatment. There was no differential weight change associated with nortriptyline vs. paroxetine. Rather, subjects in both groups approximated their premorbid weights by 12 weeks of acute-phase pharmacotherapy with either agent. However, additional investigation of weight change during continuation and maintenance pharmacotherapy is necessary and would be clinically useful for the long-term management of elderly patients with depression.

Key Words: Antidepressants • Weight Change • Randomized Trials • Paroxetine • Nortriptyline

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