title: Duloxetine in elderly major depression disorder: effectiveness and drug plasma level evaluation.
abstract: The aim of this open-label naturalistic study was to assess clinical outcomes and the predictive value of duloxetine plasma levels in major depressive disorder in the elderly.
  
  
  
  This naturalistic, open-label design involved 35 outpatients aged between 65 and 87 years. Duloxetine plasma levels were collected in 24 patients after the first month. Patients were evaluated using 21-item Hamilton Rating Scales for Depression, Hamilton Rating Scales for Anxiety, the Clinical Global Impression Severity, Mini Mental State Examination, Cumulative Illness Rating Scale, Barthel Index and Beck's Depression Inventory.
  
  
  
  Duloxetine plasma levels at T2 ranged from 4.9 to 201.9 ng/mL without a significant correlation between duloxetine dose and plasma levels. A significant improvement in mean 21-item Hamilton Rating Scales for Depression total scores at T2,T3, T4, T9 and T12 and a progressive significantly decrease of the mean Hamilton Rating Scales for Anxiety scores from T3 to T12 were observed.
  
  
  
  The levels of duloxetine in plasma do not correlate with a greater clinical improvement, indeed appear to adversely affect the improvement of the Beck Depression Inventory and Hamilton Rating Scales for Anxiety. This could be explained by an increase in side effects that may aggravate the discomfort felt by the patient. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Neuroscience and Mental Health, Clinical Psychiatry, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy. chiara.rovera@libero.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rovera
authors.affiliation: Department of Neuroscience and Mental Health, Clinical Psychiatry, Clinical Psychopharmacology Unit, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
authors.forename: Massimo Carlo
authors.initials: MC
authors.lastname: Mauri
authors.affiliation: Geriatric Unit, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bertin
authors.affiliation: Department of Neuroscience and Mental Health, Clinical Psychiatry, Clinical Psychopharmacology Unit, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Di Pace
authors.affiliation: Department of Neuroscience and Mental Health, Clinical Psychiatry, Clinical Psychopharmacology Unit, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Paletta
authors.affiliation: Department of Neuroscience and Mental Health, Clinical Psychiatry, Clinical Psychopharmacology Unit, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Reggiori
authors.affiliation: Department of Neuroscience and Mental Health, Clinical Psychiatry, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
authors.forename: Ilaria Francesca
authors.initials: IF
authors.lastname: De Gaspari
authors.affiliation: Unit of Clinical Pharmacology, L. Sacco University Hospital, Milan, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Cattaneo
authors.affiliation: Geriatric Unit, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Mari
authors.affiliation: Department of Neuroscience and Mental Health, Clinical Psychiatry, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.
authors.forename: Alfredo Carlo
authors.initials: AC
authors.lastname: Altamura
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D000068736:Duloxetine Hydrochloride / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D016896:Treatment Outcome
chemical_list: D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; D000068736:Duloxetine Hydrochloride
keywords: duloxetine; elderly; major depressive disorder; plasma level