Key result
Imipramine causes a ~26 mmHg systolic postural drop vs doxepin and placebo in geriatric outpatients.
Why the study?
Does imipramine or doxepin increase orthostatic hypotension compared to placebo in depressed geriatric outpatients?
Population
36 depressed geriatric outpatients (ages 55 to 81 years)
Comparison
Imipramine and doxepin vs Placebo
Design
RCT, double-blind
Authors
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Clinicians should avoid imipramine in favor of doxepin for geriatric depression to reduce orthostatic risk; reinforces differential TCA effects in RCTs.
RCT (n=36)
Double-blind
Does imipramine or doxepin increase orthostatic hypotension compared to placebo in depressed geriatric outpatients?
Absolute Event Rate: 25.9% vs 12.4%
Imipramine causes significantly greater orthostatic hypotension compared to doxepin and placebo in depressed geriatric outpatients, warranting caution in its use.
Neshkes et al. (1985) conducted an RCT in Depression (n=36). Imipramine and doxepin vs. Placebo was evaluated on Mean systolic postural changes. Imipramine caused a significantly higher mean systolic postural drop (25.9 mm Hg) compared to doxepin (10.5 mm Hg) and placebo (12.4 mm Hg) in depressed geriatric outpatients.
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