Key result
SSRIs equal other antidepressants in elderly depression but reduce side effects and dropouts versus tricyclics.
Why the study?
The efficacy and side-effect profiles of SSRIs compared to placebo or other antidepressants in elderly depressed patients required qualitative analysis.
Do selective serotonin reuptake inhibitors (SSRIs) improve efficacy and reduce side-effects compared to placebo or other antidepressants in elderly people with depression?
Systematic Review
Do selective serotonin reuptake inhibitors (SSRIs) improve efficacy and reduce side-effects compared to placebo or other antidepressants in elderly people with depression?
SSRIs are as effective as other antidepressants in elderly depressed patients but offer a more favorable side-effect profile and lower dropout rates compared to TCAs.
Supports preferring SSRIs over TCAs in elderly depression for tolerability; reinforces Level 1 evidence guiding first-line selection.
A qualitative analysis of studies on the efficacy and side-effects of selective serotonin reuptake inhibitors (SSRIs) for the treatment of elderly people with depression is presented. Only placebo-controlled or comparison studies of SSRI versus other antidepressants were included. The description and methodological quality of the analysed studies were important criteria in the outcome of the analysis. Quality was assessed by means of a blinded review approach. After excluding duplicate publications, 16 studies were analysed, of which six turned out to be of good quality. The results indicated that at the end of the treatment periods (4-8 weeks) all antidepressants were equally effective. Side-effects occurred less frequently with SSRIs than with tricyclics (TCAs), and different side-effect profiles were found. Significantly fewer SSRI-treated patients than TCA-treated patients dropped out both overall and due to side-effects.
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Menting et al. (1996) conducted a systematic review in depression. Selective serotonin reuptake inhibitors (SSRIs) vs. Placebo or other antidepressants (e.g., tricyclics) was evaluated on efficacy and side-effects. SSRIs were equally effective as other antidepressants in elderly depressed patients, but resulted in fewer side-effects and significantly lower dropout rates than tricyclics.
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