Recurrence of first-episode geriatric depression after discontinuation of maintenance antidepressants.
OBJECTIVE
Later age at onset of depression appears to be a risk factor for early recurrence. Therefore, the authors examined the 2-year outcomes of elderly patients with first-episode major depression following discontinuation of their maintenance antidepressant medication.


METHODS
The study group consisted of 21 elderly patients who had recovered from a first lifetime episode of major depression. They had taken maintenance antidepressant medication for 2 years and had not had a relapse or recurrence during that time. The antidepressant was then withdrawn, and patients were followed for another 2 years or until recurrence, whichever occurred first.


RESULTS
The cumulative probability of suffering a recurrence of major depression was 61%. Eleven of the 12 patients who suffered a recurrence restarted the antidepressant, and 10 responded.


CONCLUSIONS
Elderly patients with first-episode major depression were at high risk of recurrence following discontinuation of maintenance antidepressant medication. However, the vast majority of patients who experienced a recurrence responded to reinstated treatment.
Flint
A J
AJ
Geriatric Psychiatry Program, Toronto Hospital, Ont., Canada. aflint@torhosp.toronto.on.ca
Rifat
S L
SL
D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000009:adverse effects / Q000627:therapeutic use; D010624:Phenelzine / Q000009:adverse effects / Q000627:therapeutic use; D011336:Probability; D012008:Recurrence; D012307:Risk Factors; D013375:Substance Withdrawal Syndrome / Q000209:etiology*
D000928:Antidepressive Agents; D009661:Nortriptyline; D010624:Phenelzine