How Long Should the Elderly Take Antidepressants?

1993 ◽  
Vol 162 (2) ◽  
pp. 175-182 ◽  
Author(s):  
◽  
Robin Jacoby ◽  
A. Daniel Lunn ◽  
M. Ardern ◽  
K. Bergmann ◽  
...  
Keyword(s):  
Relative Risk ◽  
Controlled Trial ◽  
Antidepressant Medication ◽  
The Elderly ◽  
Depressive Illness ◽  
Favourable Outcome ◽  
Elderly Persons ◽  
Major Depressive ◽  
Double Blind ◽  
Risk Of Relapse

Of 219 elderly patients with a major depressive disorder (meeting RDC), 69 recovered sufficiently and consented to enter a two-year double-blind placebo-controlled trial of dothiepin. Survival analysis revealed that dothiepin reduced the relative risk of relapse by two and a half times. Past but not current serious physical illness was also associated with a favourable outcome, whereas a prolonged index depressive illness trebled the relative risk of relapse. In the light of previous research on prognosis it is suggested that elderly persons who recover from a major depressive illness should continue with antidepressant medication for at least two years, if not indefinitely.

Placebo-Controlled Trial of Lithium Augmentation of Fluoxetine and Lofepramine

1995 ◽  
Vol 166 (1) ◽  
pp. 80-86 ◽  
Author(s):  
Cornelius L. E. Katona ◽  
Mohammed T. Abou-Saleh ◽  
Deborah A. Harrison ◽  
Bertrand A. Nairac ◽  
Denzil R. L. Edwards ◽  
...  
Keyword(s):  
Rating Scale ◽  
Antidepressant Treatment ◽  
Controlled Trial ◽  
Depressive Illness ◽  
Controlled Trials ◽  
Major Depressive ◽  
Double Blind ◽  
Primary Care Settings ◽  
Resistant Depression ◽  
Lithium Augmentation

BackgroundThis study was designed to establish whether (as suggested in a number of open and relatively small controlled trials) lithium augmentation is more effective than continued antidepressant alone, where response to a standard course of antidepressant treatment has been absent or partial.MethodLithium or placebo was added on a double-blind basis for six weeks to the drug regime of 62 patients with major depressive illness (in both hospital and primary care settings) who had failed to respond to a controlled trial of fluoxetine or lofepramine. Response was defined as a final Hamilton Depression Rating Scale (HDRS) score of < 10.ResultsResponse was seen more frequently in patients taking lithium (15/29) than in those remaining on antidepressant alone (8/32; P < 0.05). Rapid response to lithium augmentation (LA) was not consistently observed in this cohort. Mean HDRS scores after six weeks were significantly lower (P < 0.01) in the lithium group after excluding those who had not achieved significant exposure to lithium (arbitrarily defined as two or more lithium levels ≥ 0.4 mmol/1). No differences in the efficacy of LA were apparent between fluoxetine and lofepramine.ConclusionsOur results confirm that LA is a useful strategy in the treatment of antidepressant-resistant depression. Partial response was, however, frequently observed with continued antidepressant treatment alone, and the superiority of LA appears to depend on achieving adequate serum lithium levels.

Low Selenium Status in the Elderly Influences Thyroid Hormones

1995 ◽  
Vol 89 (6) ◽  
pp. 637-642 ◽  
Author(s):  
Oliviero Olivieri ◽  
Domenico Girelli ◽  
Margherita Azzini ◽  
Anna Maria Stanzial ◽  
Carla Russo ◽  
...  
Keyword(s):  
Glutathione Peroxidase ◽  
Thyroid Hormones ◽  
Peroxidase Activity ◽  
Controlled Trial ◽  
The Elderly ◽  
Serum Selenium ◽  
Selenium Status ◽  
Glutathione Peroxidase Activity ◽  
Double Blind ◽  
Double Blind Placebo

1. Iodothyronine 5′-deiodinase, which is mainly responsible for peripheral triiodothyronine (T3) production, has recently been demonstrated to be a selenium-containing enzyme. In the elderly, reduced peripheral conversion of thyroxine (T4) to T3 and overt hypothyroidism are frequently observed. 2. We measured serum selenium and erythrocyte glutathione peroxidase (as indices of selenium status), thyroid hormones and thyroid-stimulating hormone in 109 healthy euthyroid subjects (52 women, 57 men), carefully selected to exclude abnormally low thyroid hormone levels induced by acute or chronic diseases or calorie restriction. The subjects were subdivided into three age groups. To avoid conditions of undernutrition or malnutrition, dietary records were obtained for a sample of 24 subjects, randomly selected and representative of the whole population for age and sex. 3. In order to properly assess the influence of selenium status on iodothyronine 5′-deiodinase type I activity, a double-blind placebo-controlled trial was also carried out on 36 elderly subjects, resident at a privately owned nursing home. 4. In the free-living population, a progressive reduction of the T3/T4 ratio (due to increased T4 levels) and of selenium and erythrocyte glutathione peroxidase activity was observed with advancing age. A highly significant linear correlation between T4, T3/T4 and selenium was observed in the population as a whole (for T4, R = −0.312, P < 0.002; for T3/T4 ratio, R = 0.32, P < 0.01) and in older subjects (for T4, R = −0.40, P < 0.05; for T3/T4 ratio, R = 0.54, P < 0.002). 5. The main result of the double-blind placebo-controlled trial was a significant improvement of selenium indices and a decrease in the T4 level in selenium-treated subjects; serum selenium, erythrocyte glutathione peroxidase activity and thyroid hormones did not change in placebo-treated subjects. 6. We concluded that selenium status influences thyroid hormones in the elderly, mainly modulating T4 levels.

scholarly journals Effects of exergame training combined with omega-3 fatty acids on the elderly brain: a randomized double-blind placebo-controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alexandra Schättin ◽  
Corinne Baier ◽  
Domenique Mai ◽  
Verena Klamroth-Marganska ◽  
Isabelle Herter-Aeberli ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Controlled Trial ◽  
The Elderly ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals A Randomized, Double-Blind, Placebo-Controlled Trial of Escitalopram in Patients with Asthma and Major Depressive Disorder

2018 ◽  
Vol 6 (5) ◽  
pp. 1604-1612 ◽  
Author(s):  
E. Sherwood Brown ◽  
Nasreen Sayed ◽  
Erin Van Enkevort ◽  
Alexandra Kulikova ◽  
Alyson Nakamura ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Controlled Trial ◽  
Major Depressive ◽  
Double Blind ◽  
Double Blind Placebo

A Randomized, Double-Blind, Placebo-Controlled Trial of Pramipexole Augmentation in Treatment-Resistant Major Depressive Disorder

2013 ◽  
Vol 74 (07) ◽  
pp. e636-e641 ◽  
Author(s):  
Cristina Cusin ◽  
Nadia Iovieno ◽  
Dan V. Iosifescu ◽  
Andrew A. Nierenberg ◽  
Maurizio Fava ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Controlled Trial ◽  
Treatment Resistant ◽  
Major Depressive ◽  
Double Blind ◽  
Double Blind Placebo
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