The Use of Antidepressants in the Elderly: 1986 and 1989

Dewan, Mantosh; Huszonek, John J.; Koss, Marvin; Hardoby, William; Ispahani, Abbas

doi:10.1177/002383099200500107

Cited by 20 publications

(6 citation statements)

References 16 publications

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“…The older antidepressants, particularly amitriptyline, caused the most side-effects, confirming previous strong recommendations that these be avoided (Gerson et al, 1988;Dewan et al, 1992). Given its marked side-effect profile, amitriptyline, when used as a comparator, may have exaggerated the beneficial side-effect profile of newer drugs.…”

Section: Tertiary Aminessupporting

confidence: 68%

Antidepressants and the elderly: Double‐blind trials 1987‐1992

Anstey

Brodaty

1995

Int J Geriat Psychiatry

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SUMMARYWe reviewed all double-blind antidepressant trials reported between 1987 and 1992 in samples of people aged 55 years or more with a primary diagnosis of major or clinical depression. There was an increase in the annual rate of trials conducted compared with the period from 1964 to 1986. About 27% of patients commencing trials withdrew prior to completion. Of those who completed, there was a general reduction of about 55% in scores on the Hamilton Rating Scale for Depression. No differences in efficacy between drugs were found. Newer antidepressants, particularly selective serotonin reuptake inhibitors, appeared to have fewer side-effects, but methodological shortcomings limited interpretation of the results. Recommendations for future research are proposed.

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Section: Tertiary Aminessupporting

confidence: 68%

Antidepressants and the elderly: Double‐blind trials 1987‐1992

Anstey

Brodaty

1995

Int J Geriat Psychiatry

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“…One might suppose that doctors might have prescribed tricyclics with caution and that the advent of 'safer' serotonin reuptake inhibitors might have changed prescribing habits. However, Dewan et al (1992) found that in comparing the use of antidepressants in the elderly in 1986 and 1989, in 1986 antidepressants were prescribed in quantities that were directly proportional to their side-effects, ie the greater the side-effects, the more they were used.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with recovery and recurrence of depression in older people: A prospective study

Green

Copeland

Dewey

et al. 1994

Int J Geriat Psychiatry

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SUMMARYThe Liverpool Continuing Health in the Community Study has followed up 1070 elderly community subjects over 6 years. In the first year 123 subjects had case-level depression. Three years later 49 (39.8%) of the previously depressed were recovered, 33 (26.8%) were depressed, 16 (13%) were not available for interview and 25 (20.3%) were dead. This study looks at factors associated with the 3-year outcome of patients who were depressed at year 0. Two outcome groups that were compared were a recovered depression group and a recurrent/persistent depression group. The factors that were significantly associated with a recurrence of depression (or persistent depression) at year 3 were bereavement of a close figure in the 6 months before interview, loneliness and life dissatisfaction at year 3. A variety of traditional risk factors for depression (including age, marital status, physical ill-health and incapacity) failed to attain significance in predicting recurrent or persistent depression. When combined, both recovered and recurrently depressed groups at year 3 had significantly higher levels of pain and a higher number of serious upsets in the past 6 months and 6 weeks compared to a control group. The depressed at year 0 were more likely to have entered more dependent forms of accommodation by year 3.

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“…Lastly, specific psychotherapies can be examined, such as cognitive behavioral therapy (CBT), but more attention should also be given to effects of the most common kind of psychotherapy, a nonspecific eclectic mix of mostly psychoanalytic techniques with supportive and behavioral methods, which is highly understudied (66). A final kind of psychotherapy that is little studied and may have particular benefit in depressive conditions is existential psychotherapy (67), which, despite its apparently subjective nature, is amenable to empirical assessment of outcomes (68).…”

Section: Suggestions For Future Researchmentioning

confidence: 99%

Why antidepressants are not antidepressants: STEP‐BD, STAR*D, and the return of neurotic depression

Ghaemi

2008

Bipolar Disorders

119

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The widely held clinical view of 'antidepressants' as highly effective and specific for the treatment of all types of depressive disorders is exaggerated. This sobering conclusion is supported by recent findings from the NIMH-sponsored STEP-BD and STAR*D projects. Antidepressants have limited short-term efficacy in unipolar depressive disorders and less in acute bipolar depression; their long-term prophylactic effectiveness in recurrent unipolar major depression remains uncertain, and is doubtful in recurrent bipolar depression. These limitations may, in part, reflect the excessively broad concept of major depression as well as unrealistic expectations of universal efficacy of drugs considered 'antidepressants.' Treatment-refractory depression may reflect failure to distinguish depressive conditions, particularly bipolar disorder, that are inherently less responsive to antidepressants. Antidepressants probably should be avoided in bipolar depression, mixed manic-depressive states, and in neurotic depression. Expectations of antidepressants for specific types of patients with symptoms of depression or anxiety require critical re-evaluation. A revival of the concept of neurotic depression would make it possible to identify patients with mild-to-moderate, chronic or episodic dysthymia and anxiety who are unlikely to benefit greatly from antidepressants. Diagnostic criteria for a revival of the concept of neurotic depression are proposed.

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The Use of Antidepressants in the Elderly: 1986 and 1989

Cited by 20 publications

References 16 publications

Antidepressants and the elderly: Double‐blind trials 1987‐1992

Antidepressants and the elderly: Double‐blind trials 1987‐1992

Factors associated with recovery and recurrence of depression in older people: A prospective study

Why antidepressants are not antidepressants: STEP‐BD, STAR*D, and the return of neurotic depression

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