An open-label, randomized, prospective comparison of sertraline and amisulpride in the treatment of dysthymia in the elderly

In recent years, controlled trials have documented the efficacy of numerous antidepressant drugs in the treatment of dysthymia, particularly the selective serotonin reuptake inhibitors (SSRIs) and substituted benzamides such as amisulpride. However, very little has been published on pharmacologic approaches to this disorder in the elderly. An open-label, randomized, prospective trial was performed on 49 dysthymic patients, 65 years of age or older, assigned randomly to two different treatments: an SSRI-sertraline-or a substituted benzamide-amisulpride-both at a daily dose of 50 mg. Treatment was continued for 6 months, and clinical assessment was based on the Hamilton rating scales for depression and anxiety and on Brink's scale for depression in the elderly. Analysis of variance showed that both treatments were effective over this observation period. Comparison of the differences in mean scores and the numbers of responders after 3 and 6 months of treatment by using Student's t test showed no statistically significant differences. The lack of significant differences between treatments could be attributed to the small size of the study population. Elderly patients tolerated both drugs well, and there was a low incidence of side effects and dropouts reported.