Paroxetine and fluoxetine effects on mood and cognitive functions in depressed nondemented elderly patients.

Full Abstract

BACKGROUND:
A large proportion of the elderly population complains of depressive symptoms. The ideal antidepressant for these patients, who often suffer from numerous concomitant diseases, should not worsen their cognitive functions and should be free of contraindications.

METHOD:
To assess the effects of 2 selective serotonin reuptake inhibitors on cognitive functions in elderly depressed patients (ICD-10 criteria), we conducted a double-blind, randomized, parallel-group, multicenter study comparing paroxetine (20-40 mg daily) and fluoxetine (20-60 mg daily) treatment for 1 year. Cognitive performance was evaluated by means of the Buschke Selective Reminding Test, the Blessed Information and Memory Test, the Clifton Assessment Schedule, the Cancellation Task Test, and the Wechsler Paired Word Test; the Hamilton Rating Scale for Depression (HAM-D) and the Clinical Anxiety Scale were administered to assess the course of depressive and anxiety symptoms, respectively.

RESULTS:
242 patients were enrolled (mean +/- SD age = 75.4 +/- 6.6 years). During the study, no deterioration of cognition was observed; on the contrary, most of the tested cognitive functions improved. Good antidepressant efficacy was maintained for over 1 year with both drugs, based on the percentage of responders to treatment (patients achieving a HAM-D total score < 10; 60%). Both drugs showed a good tolerability and safety profile.

CONCLUSION:
The 2 antidepressants proved to be suitable for the long-term treatment of depression in the elderly and to be devoid of detrimental effects on the tested cognitive functions.

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Author information

Author/s: Cassano, Giovanni Battista (GB); Puca, Francomichele (F); Scapicchio, Pier Luigi (PL); Trabucchi, Marco (M); Italian Study Group on Depression in Elderly Patients;

Affiliation: Department of Psychiatry, University of Pisa, S Chiara Hospital, Italy. gcassano(-atsign-)psico.med.unipi.it

Journal and publication information

Publication Type: Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: The Journal of clinical psychiatry (J Clin Psychiatry), published in United States. (Language: eng)

Reference: 2002-May; vol 63 (issue 5) : pp 396-402

Dates: Created 2002/05/21; Completed 2002/06/06; Revised 2006/11/15;

PMID: 12019663, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Affect - drug effects
Age Factors
Aged
Ambulatory Care
Anxiety Disorders - diagnosis; drug therapy; psychology
Cognition - drug effects
Depressive Disorder - diagnosis; drug therapy; psychology
Double-Blind Method
Female

Female
Fluoxetine - pharmacology; therapeutic use
Humans
Male
Paroxetine - pharmacology; therapeutic use
Psychiatric Status Rating Scales
Serotonin Uptake Inhibitors - therapeutic use
Survival Analysis
Treatment Outcome

Associated Chemicals: Serotonin Uptake Inhibitors (0) ; Fluoxetine (54910-89-3) ; Paroxetine (61869-08-7)

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