Antidepressant medication and executive dysfunction: a deleterious interaction in late-life depression.
OBJECTIVE
To determine whether there is differential response to placebo or citalopram among older patients with and without deficient response inhibition (DRI).


METHODS
This is an 8-week, double-blind, placebo-controlled trial.


METHODS
Outpatient psychiatry.


METHODS
Unipolar depressed patients aged 75 years and older.


METHODS
Citalopram (20-40 mg/day) or placebo pill.


METHODS
Baseline Stroop Color-Word Test and weekly 24-item Hamilton Rating Scale for Depression assessments.


RESULTS
Citalopram-treated patients with DRI did significantly worse than placebo-treated patients with DRI. Conversely, citalopram-treated patients without DRI did significantly better than placebo-treated patients without DRI.


CONCLUSIONS
Patients with late-life depression and DRI respond worse to selective serotonin reuptake inhibitor (SSRI) than placebo. These findings suggest that there may be a deleterious interaction between DRI and antidepressant medication in late-life depression and that the mechanism of SSRI and placebo response is different.
Sneed
Joel R
JR
Queens College of the City University of New York, Flushing, NY 11367, USA. joel.sneed@qc.cuny.edu
Culang
Michelle E
ME
Keilp
John G
JG
Rutherford
Bret R
BR
Devanand
Davangere P
DP
Roose
Steven P
SP
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D015283:Citalopram / Q000009:adverse effects*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D056344:Executive Function / Q000187:drug effects*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D016896:Treatment Outcome
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors