Antidepressants in elderly: Metaregression of double-blind, randomized clinical trials

Calati, Raffaella; Signorelli, Maria Salvina; Balestri, Martina; Marsano, Agnese; Ronchi, Diana De; Aguglia, Eugenio; Serretti, Alessandro

doi:10.1016/j.jad.2012.11.053

Cited by 83 publications

(73 citation statements)

References 78 publications

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“…To advance this issue, we used information from meta-analyses and reviews summarizing clinical trials and longitudinal observational studies on the effects of antidepressants on depressive symptoms scores. On average, antidepressants achieve a reduction in symptom score of 45% (55)(56)(57)(58)(59). Based on this average reduction, an IDS score for the antidepressant users was calculated that was more likely to represent their severity before they started using this antidepressant (by dividing their current IDS score by 0.55).…”

Section: Clinical Characteristicsmentioning

confidence: 99%

The Association Between Depressive Disorder and Cardiac Autonomic Control in Adults 60 Years and Older

Licht

Naarding

Penninx

et al. 2015

Psychosomatic Medicine

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Section: Clinical Characteristicsmentioning

confidence: 99%

The Association Between Depressive Disorder and Cardiac Autonomic Control in Adults 60 Years and Older

Licht

Naarding

Penninx

et al. 2015

Psychosomatic Medicine

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“…Although late-life depression can be treated effectively, there is space for both improvement and development of alternative treatments [9, 13, 14]. Furthermore, especially in older adults, the use of psychoactive agents like antidepressants is associated with risks and adverse events, such as falls and adverse interactions with somatic medications [2, 15, 16].…”

Section: Introductionmentioning

confidence: 99%

Behavioural activation by mental health nurses for late-life depression in primary care: a randomized controlled trial

et al. 2017

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BackgroundDepressive symptoms are common in older adults. The effectiveness of pharmacological treatments and the availability of psychological treatments in primary care are limited. A behavioural approach to depression treatment might be beneficial to many older adults but such care is still largely unavailable. Behavioural Activation (BA) protocols are less complicated and more easy to train than other psychological therapies, making them very suitable for delivery by less specialised therapists. The recent introduction of the mental health nurse in primary care centres in the Netherlands has created major opportunities for improving the accessibility of psychological treatments for late-life depression in primary care. BA may thus address the needs of older patients while improving treatment outcome and lowering costs.The primary objective of this study is to compare the effectiveness and cost-effectiveness of BA in comparison with treatment as usual (TAU) for late-life depression in Dutch primary care. A secondary goal is to explore several potential mechanisms of change, as well as predictors and moderators of treatment outcome of BA for late-life depression.Methods/designCluster-randomised controlled multicentre trial with two parallel groups: a) behavioural activation, and b) treatment as usual, conducted in primary care centres with a follow-up of 52 weeks. The main inclusion criterion is a PHQ-9 score > 9. Patients are excluded from the trial in case of severe mental illness that requires specialized treatment, high suicide risk, drug and/or alcohol abuse, prior psychotherapy, change in dosage or type of prescribed antidepressants in the previous 12 weeks, or moderate to severe cognitive impairment. The intervention consists of 8 weekly 30-min BA sessions delivered by a trained mental health nurse.DiscussionWe expect BA to be an effective and cost-effective treatment for late-life depression compared to TAU. BA delivered by mental health nurses could increase the availability and accessibility of non-pharmacological treatments for late-life depression in primary care.Trial registrationThis study is retrospectively registered in the Dutch Clinical Trial Register NTR6013 on August 25th 2016.

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“…Furthermore, SSRIs appeared to be less effective in patients with severe depression (HAMD >23) (Bose et al, 2008;Roose et al, 2004;Schatzberg and Roose, 2006) than in patients with a moderate severity of depression (Dombrovski et al, 2007;Nyth et al, 1992;Rapaport et al, 2003;Schneider et al, 2003;Sheikh et al, 2004). However, a metaanalysis study suggested that SSRIs are more effective in patients who show higher baseline severity at a first episode of illness (Calati et al, 2013). Interestingly, in this meta-analysis it was observed that SSRIs displayed a lower response rate in male patients and in patients of old age (Calati et al, 2013).…”

Section: Clinical Insightsmentioning

confidence: 71%

“…However, a metaanalysis study suggested that SSRIs are more effective in patients who show higher baseline severity at a first episode of illness (Calati et al, 2013). Interestingly, in this meta-analysis it was observed that SSRIs displayed a lower response rate in male patients and in patients of old age (Calati et al, 2013). Importantly, among the trials included in our evaluation only one study was conducted in very old patients (≥75) (Roose et al, 2004).…”

Section: Clinical Insightsmentioning

confidence: 85%

When ageing meets the blues: Are current antidepressants effective in depressed aged patients?

Felice

O’Leary

Cryan

et al. 2015

Neuroscience & Biobehavioral Reviews

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Antidepressants in elderly: Metaregression of double-blind, randomized clinical trials

Cited by 83 publications

References 78 publications

The Association Between Depressive Disorder and Cardiac Autonomic Control in Adults 60 Years and Older

The Association Between Depressive Disorder and Cardiac Autonomic Control in Adults 60 Years and Older

Behavioural activation by mental health nurses for late-life depression in primary care: a randomized controlled trial

When ageing meets the blues: Are current antidepressants effective in depressed aged patients?

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