A double-blind comparison of the efficacy and safety of paroxetineand imipramine in the treatment of depression with dementia
C.L.E. Katona
Bok Engelsk 1998
| Utgitt | 1998
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| Omfang | Side 100- 108
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| Opplysninger | Objectives. To compare the efficacy of paroxetine and imipramineprospectively in patients with coexisting depression and dementia.Methods. An 8-week, double-blind, parallel group trial comparingparoxetine 20-40 mg/day with imipramine 50-100 mg/day in 198 patientsaged 60 years or over with a Montgomery-Asberg Depression RatingScale (MADRS) score greater than or equal to 20 and a Folstein mini-mental state evaluation score of 17-23 points after a 3- to 7-dayplacebo run-in period.Results. Both paroxetine and imipramine reduced the MADRS and theClinical Global Impression (CGI) severity-of-illness and globalimprovement scores at weeks 2, 4, 8 and at endpoint, with nosignificant differences between treatment groups at any timepoint(MADRS, p greater than or equal to 0.368; cgi, p greater than orequal to 0.286). There was a statistically significant difference infavour of paroxetine at both the week 4 and week 8 timepoints(analysis of variance, p less than or equal to 0.049) in the Cornellscale for depression in dementia: at endpoint there was nosignificant difference between treatments (p = 0.103). Treatment-emergent adverse experiences were reported by 51.5% (51/99) ofpatients treated with paroxetine and 50.5% (50/99) of patientstreated with imipramine. Anticholinergic adverse experiences(paroxetine 6.1%; imipramine 13.1%) and serious non-fatal adverseexperiences (paroxetine 4.0%; imipramine 8.1%) were reported by morepatients in the imipramine group than in the paroxetine group.Conclusions. Paroxetine and imipramine were both effective in thetreatment of depression in elderly subjects with co-existingdementia, and no significant differences were detected between thegroups. There were trends suggesting that paroxetine was bettertolerated than imipramine in terms of anticholinergic adverseexperiences and serious non-fatal adverse experiences. (C) 1998 JohnWiley & Sons, Ltd.
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| Emner |
