title: Effect of increasing the dose and duration of sertraline trial in the treatment of depressed nursing home residents.
abstract: There has been limited research into defining what constitutes an adequate first-line antidepressant trial in elderly patients. The authors report the outcome of extended, high-dosage sertraline treatment in a sample of nursing home residents experiencing residual significant depressive symptoms after 10 weeks of treatment with sertraline at a final dosage of 100 mg/day. Subjects who had a Hamilton Depression Rating Scale score > or = 12 after 10 weeks of treatment with sertraline were eligible for the 8-week open-label extension phase, which involved titrating the sertraline dosage to 200 mg/day. The cumulative response rate was 52% for the extension phase, compared with 37% for the acute phase. Examining acute phase nonresponders, 39% responded during the extension phase. Rates of discontinuation due to adverse events were comparable in the 2 phases. Our findings suggest that an extended trial or high dosages of sertraline may benefit some depressed elderly patients with persistent depression after acute treatment.
authors.affiliation: Section of Geriatric Psychiatry, University of Pennsylvania, and Philadelphia VA Medical Center, USA. weintrau@mail.med.upenn.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Weintraub
authors.forename: Joel E
authors.initials: JE
authors.lastname: Streim
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Datto
authors.forename: Ira R
authors.initials: IR
authors.lastname: Katz
authors.forename: Suzanne D
authors.initials: SD
authors.lastname: DiFilippo
authors.forename: David W
authors.initials: DW
authors.lastname: Oslin
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline