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

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.