The aim of our work was the estimation of therapeutic efficacy, as wen as tolerability of two new generation antidepressants with various mechanisms of pharmacological action in elderly patients with depression.
Sixty patients over 60 who met diagnostic criteria for depression in the course or unipolar or bipolar affective illness according DSM-IV criteria, hospitalised at Department of Adult Psychiatry were inc1uded in the study. Forty four patients had also various somatic illnesses (e.g. hypertension, diabetes), requiring separate treatment.
30 patients were treated with fluvoxamine, a selective serotonin reuptake inhibitor in dose 150-300 mg daily and 30 patients received tianeptine, drug which enhances serotonin reuptake and regulates hypothalamic-pituitary-adrenal axis, in dose 37.5 mg daily, for 6 weeks. The evaluation of c1inical state was made using the Hamilton Depression Rating Seale (HAMD) and Clinical Global Impression (CGI) scale before treatment and after 3 and 6 weeks of therapy. The assessment of somatic status and laboratory tests were done on the same days.
The mean pretreatment HAMD score was similar for both groups, on the average 24 points. After 6 weeks of therapy a marked improvement (50% reduction of HAMD score) was observed in 20 patients (70%) in the fluvoxamine group and in 15 persons (50%) who received tianeptine. Both drugs were wen tolerated by patients. 9 patients who were treated with fluvoxamine reported transient nausea, somnolence and headaches. In the tianeptine group, only 4 patients had similar symptoms 3 weeks of therapy. In both groups any abnorma1ities in laboratory tests and circulatory system or the worsening of concomitant somatic conditions were not noted.
Our study confirmed reports of other authors concerning the effectiveness and safety of fluvoxamine and tianeptine in elderly patients with depression.