title: Antidepressants in elderly: metaregression of double-blind, randomized clinical trials.
abstract: BACKGROUND
  Depression is common in the elderly and in the last few years this led to a significant increase in antidepressant prescription rates. However, little is known about antidepressant efficacy profile in relation with socio-demographic and clinical features in this population. The aim of the present study was to define the most suitable socio-demographic and clinical profile for the use of antidepressant treatments in late-life depression.
  
  
  METHODS
  MEDLINE, EMBASE and PsycINFO were searched for randomized controlled trials (RCTs) focused on efficacy of antidepressants of all classes in major depressed elderly subjects (>60 years old). Reviews and meta-analyses focusing on this topic have been considered as well. Thirty-four RCTs were included and socio-demographic and clinical features were investigated via meta-regression analysis as moderators of efficacy measures (standardized mean difference based on Hamilton Depressive Rating Scale and Montgomery-Asberg Depression Rating Scale).
  
  
  RESULTS
  A lower rate of response to antidepressants of all classes was found in patients of male gender, of older age, and with a longer mean duration of the current episode. On the contrary, a higher rate of response was found in patients with a higher baseline severity and at their first episode of illness. Subsamples treated with selective serotonin reuptake inhibitors alone yielded similar results.
  
  
  CONCLUSIONS
  RCTs only have been included.
  
  
  CONCLUSIONS
  A number of socio-demographic and clinical features have been found to moderate antidepressant efficacy in elderly population. Those variables could help clinicians for a more individualized treatment.
authors.affiliation: IRCCS Centro S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Calati
authors.forename: Maria
authors.initials: M
authors.lastname: Salvina Signorelli
authors.forename: Martina
authors.initials: M
authors.lastname: Balestri
authors.forename: Agnese
authors.initials: A
authors.lastname: Marsano
authors.forename: Diana
authors.initials: D
authors.lastname: De Ronchi
authors.forename: Eugenio
authors.initials: E
authors.lastname: Aguglia
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serretti
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors