title: Complementary use of tai chi chih augments escitalopram treatment of geriatric depression:  a randomized controlled trial.
abstract: BACKGROUND
  Nearly two-thirds of elderly patients treated for depression fail to achieve symptomatic remission and functional recovery with first-line pharmacotherapy. In this study, we ask whether a mind-body exercise, Tai Chi Chih (TCC), added to escitalopram will augment the treatment of geriatric depression designed to achieve symptomatic remission and improvements in health functioning and cognitive performance.
  
  
  METHODS
  : One hundred twelve older adults with major depression age 60 years and older were recruited and treated with escitalopram for approximately 4 weeks. Seventy-three partial responders to escitalopram continued to receive escitalopram daily and were randomly assigned to 10 weeks of adjunct use of either 1) TCC for 2 hours per week or 2) health education (HE) for 2 hours per week. All participants underwent evaluations of depression, anxiety, resilience, health-related quality of life, cognition, and inflammation at baseline and during 14-week follow-up.
  
  
  RESULTS
  Subjects in the escitalopram and TCC condition were more likely to show greater reduction of depressive symptoms and to achieve a depression remission as compared with those receiving escitalopram and HE. Subjects in the escitalopram and TCC condition also showed significantly greater improvements in 36-Item Short Form Health Survey physical functioning and cognitive tests and a decline in the inflammatory marker, C-reactive protein, compared with the control group.
  
  
  CONCLUSIONS
  : Complementary use of a mind-body exercise, such as TCC, may provide additional improvements of clinical outcomes in the pharmacologic treatment of geriatric depression.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences and the Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA. hlavrets@ucla.edu
authors.forename: Helen
authors.initials: H
authors.lastname: Lavretsky
authors.forename: Lily L
authors.initials: LL
authors.lastname: Alstein
authors.forename: Richard E
authors.initials: RE
authors.lastname: Olmstead
authors.forename: Linda M
authors.initials: LM
authors.lastname: Ercoli
authors.forename: Marquertie
authors.initials: M
authors.lastname: Riparetti-Brown
authors.forename: Natalie St
authors.initials: NS
authors.lastname: Cyr
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
mesh_terms: D000368:Aged; D001007:Anxiety / Q000150:complications / Q000523:psychology; D002097:C-Reactive Protein / Q000378:metabolism; D015283:Citalopram / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D003131:Combined Modality Therapy / Q000379:methods* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D055500:Resilience, Psychological / Q000187:drug effects; D012720:Severity of Illness Index; D026302:Tai Ji / Q000523:psychology*
chemical_list: D015283:Citalopram; D002097:C-Reactive Protein