ANTIDEPRESSANTS AND THE ELDERLY - DOUBLE-BLIND TRIALS 1987-1992

We reviewed all double-blind antidepressant trials reported between 1987 and 1992 in samples of people aged 55 years or more with a primary diagnosis of major or clinical depression. There was an increase in the annual rate of trials conducted compared with the period from 1964 to 1986. About 27% of patients commencing trials withdrew prior to completion. Of those who completed, there was a general reduction of about 55% in scores on the Hamilton Rating Scale for Depression. No differences in efficacy between drugs were found. Newer antidepressants, particularly selective serotonin reuptake inhibitors, appeared to have fewer side-effects, but methodological shortcomings limited interpretation of the results. Recommendations for future research are proposed.