Good treatment outcomes in late-life depression with comorbid anxiety.
BACKGROUND
Late-life depression studies have found that comorbid anxiety, as a symptom or comorbid disorder, is associated with poorer treatment response and increased likelihood of dropout. This study evaluated the impact of comorbid anxiety on response, dropouts, and side effects, in elderly subjects treated for depression.


METHODS
We analyzed data from a 12-week trial comparing nortriptyline and paroxetine in 116 patients aged 60 and older with depression. Subjects classified as having anxious depression were compared to those with nonanxious depression in terms of treatment response rate, time to response, dropout rate, and early side effects. The analysis was replicated with another study, in which 125 subjects aged 69 and older were treated openly with paroxetine and interpersonal psychotherapy.


RESULTS
Anxious and nonanxious groups did not differ in terms of response rates, time to response, dropout rates, or time to dropout. Side effects declined more quickly and more significantly in the anxious group than in the nonanxious group.


CONCLUSIONS
Subjects were treated in a specialty mental health setting, and the findings may not apply in other settings.


CONCLUSIONS
We found no association between comorbid anxiety and a poorer prognosis during acute treatment of late-life depression. For elderly patients with anxious depression, standardized treatment in the mental health sector is associated with a good response.
Lenze
Eric J
EJ
The Intervention Research Center in Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. lenzeej@msx.upmc.edu
Mulsant
Benoit H
BH
Dew
Mary Amanda
MA
Shear
M Katherine
MK
Houck
Patricia
P
Pollock
Bruce G
BG
Reynolds
Charles F
CF
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D009661:Nortriptyline / Q000009:adverse effects / Q000627:therapeutic use*; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use*; D010352:Patient Dropouts; D011379:Prognosis; D011613:Psychotherapy; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D017374:Paroxetine; D009661:Nortriptyline