title: Placebo-controlled treatment trial of depression in elderly physically ill patients.
abstract: OBJECTIVE
  To determine the response of physically ill elderly depressed patients to treatment.
  
  
  METHODS
  Acute geriatric medical inpatients with depression, randomly assigned to an 8-week double-blind placebo-controlled trial of fluoxetine.
  
  
  METHODS
  Response rate as defined by the 17-item Hamilton Depression Rating Scale.
  
  
  RESULTS
  Eighty-two patients entered the trial; 62 patients (all those who had completed at least 3 weeks of treatment) were included in the efficacy analysis. Forty-two completed the full 8 weeks (21 in each group) with response rates of 67% in the fluoxetine group and 38% in the placebo group. No significant difference was found between the responses of the two groups (p = 0.12). There was a trend for results in the fluoxetine group to continue to improve with time. On secondary analysis those patients with serious physical illness who completed 5 or more weeks (N = 37) showed a significant improvement in mood if treated with fluoxetine (p = 0.02).
  
  
  CONCLUSIONS
  The main benefit of antidepressants is to approximately double the chances of recovery. This trial showed the response rate of the fluoxetine treated group was increased by a factor of 1.8 over the placebo group in an 8-week period. The presence of physical illness, often severe and/or multiple, did not reduce the effectiveness of the medication, which was well tolerated overall. Those with serious physical disease responded significantly better to drug treatment; this will require further work. Psychological support was also considered to be important.
authors.affiliation: Wirral and W Cheshire Community Healthcare NHS Trust, Bebington, Wirral, UK.
authors.forename: M
authors.initials: M
authors.lastname: Evans
authors.forename: M
authors.initials: M
authors.lastname: Hammond
authors.forename: K
authors.initials: K
authors.lastname: Wilson
authors.forename: M
authors.initials: M
authors.lastname: Lye
authors.forename: J
authors.initials: J
authors.lastname: Copeland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006304:Health Status; D006801:Humans; D008297:Male; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine