The effect of sequential antidepressant treatment on geriatric depression.
This study evaluated the outcome of elderly depressed patients who were refractory to, or intolerant of, an initial trial of nortriptyline and who then underwent systematic treatment with other antidepressant therapies. 101 patients entered the study and 61% responded to nortriptyline, 64% of patients who did not improve with nortriptyline eventually responded to other antidepressant treatments. Response to second-line treatment (phenelzine) was significantly slower than response to the tricyclic antidepressant. Treatment nonresponders were more likely to have a longer episode length at index assessment and higher baseline anxiety scores compared with responders. This study demonstrates the importance of persisting with systematic antidepressant therapy in elderly patients who do not respond to the first trial of treatment.
Flint
A J
AJ
Department of Psychiatry, University of Toronto, Ontario, Canada.
Rifat
S L
SL
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D003704:Dementia / Q000188:drug therapy* / Q000523:psychology; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D016651:Lithium Carbonate / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000008:administration & dosage / Q000009:adverse effects; D010555:Personality Inventory; D010624:Phenelzine / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D016896:Treatment Outcome
D000928:Antidepressive Agents; D005473:Fluoxetine; D016651:Lithium Carbonate; D009661:Nortriptyline; D010624:Phenelzine