Multicenter Double-Blind Study of the Efficacy of Paroxetine versus Clomipramine in Elderly Patients with Major Depression

The efficacy and tolerance of paroxetine versus clomipramine were compared in 91 hospitalised subjects aged more than 60 years for whom major depression had been diagnosed. During treatment, their scores on the Hamilton Depression Scale and Montgomery-Asberg Depression Rating Scale dropped markedly compared to their scores at inclusion, without any significant differences being found at 3, 6 or 9 weeks between the condition of patients taking paroxetine and those taking clomipramine. As regards tolerance, there was significant difference between the groups for anticholinergic effects which were fewer in the paroxetine group (p = 0.038). Overall, the patients in this group experienced fewer side effects than those in the clomipramine group, and the smaller number of severe side effects in the paroxetine group caused fewer patients in this group to drop out of the study and led to less frequent attribution of side effects to drug action. Paroxetine, therefore, proved as effective as clomipramine in treating major depression in the elderly, and was somewhat better tolerated.