Citalopram Versus Sertraline in Late-Life Nonmajor Clinically Significant Depression: A 1-Year Follow-Up Clinical Trial

Paola Rocca, M.D.
 Paolo Calvarese, Ph.D.
 Fabrizio Faggiano, M.D.
 Livio Marchiaro, M.D.
 Federica Mathis, B.S.
 Elisa Rivoira, M.D.
 Barbara Taricco, Ph.D.
 Filippo Bogetto, M.D.

Objective: The aim of this study was to compare over 1 year the effect of sertraline and citalopram on depressive symptoms and cognitive functions of nondemented elderly patients with minor depressive disorder and subsyndromal depressive symptomatology.

Method: We recruited 138 consecutive nondemented outpatients of either sex, aged >= 65 years, who were classified as meeting research criteria for minor depressive disorder or subsyndromal depressive symptomatology using the Structured Clinical Interview for DSM-IV. Subjects were assigned to receive citalopram 20 mg/day (66 patients) or sertraline 50 mg/day (72 patients) orally for 1 year. Patients were assessed at baseline and after 1, 2, 3, and 6 months and at 1 year by raters masked with regard to patients' treatment assignments. The Hamilton Rating Scale for Depression, the Geriatric Depression Scale, and the Global Assessment of Functioning were administered to assess the course of depressive symptoms and social functioning during the study. Cognitive measures included Trail Making Test-Parts A and B, Wechsler Memory Scale, Mini-Mental State Examination, and a verbal fluency test. Data were collected from March 2000 to March 2003.

Results: The overall completion rate was 72%. Both treatments induced a significant, sustained, and comparable improvement in depressive symptoms and in social functioning. Nearly half of the subjects in the 2 groups achieved remitter status at study endpoint. Significant within-group improvements also were observed in all cognitive measures. Both drugs were well tolerated during the whole study period.

Conclusion: Our results suggest that sertraline and citalopram can improve depressive symptoms and cognitive functions of minor depressive disorder and subsyndromal depressive symptomatology in elderly nondemented patients.

(J Clin Psychiatry 2005;66:360-369)

This entire article is available in PDF format

Received June 18, 2004; accepted Aug. 17, 2004. From the Department of Neurosciences, Psychiatric Section (Drs. Rocca, Calvarese, Marchiaro, Rivoira, Taricco, and Bogetto), and the Department of Public Health (Dr. Faggiano and Ms. Mathis), University of Turin, Turin, Italy.

The authors received no external financial or material support for this study and report no financial affiliations or other relationships relevant to the subject matter of this article.

The authors thank Luca Cuomo, Ph.D., for the statistical analysis of data.

Corresponding author and reprints: Paola Rocca, M.D., Department of Neurosciences, Psychiatric Section, University of Turin, Via Cherasco, 11-10126 Torino, Italy (e-mail: paola.rocca@unito.it)