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Treating geriatric depression: a 26-week interim analysis

L F Jarvik, J Mintz, J Steuer

    Journal of the American Geriatrics Society
    |November 1, 1982
    PubMed
    Summary
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    Tricyclic antidepressants like imipramine and doxepin showed higher remission rates for geriatric depression compared to psychotherapy or placebo. Early drug response predicted sustained improvement in elderly patients.

    Area of Science:

    • Geriatric Psychiatry
    • Clinical Psychology
    • Pharmacology

    Background:

    • Depression is a significant health concern in geriatric outpatients.
    • Effective treatment options for depression in the elderly are crucial.

    Purpose of the Study:

    • To compare the efficacy of tricyclic antidepressants (TCAs) versus psychotherapy and placebo in treating geriatric depression.
    • To identify predictors of treatment success in this population.

    Main Methods:

    • Two concurrent studies were conducted on geriatric outpatients diagnosed with depression.
    • Study 1: Patients received imipramine, doxepin, or placebo.
    • Study 2: Patients received psychodynamic group therapy or cognitive-behavioral group therapy.

    Main Results:

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    • Placebo group showed minimal improvement.
    • Group psychotherapy yielded some improvement, with 12% full remission.
    • Imipramine and doxepin achieved 45% full remission, though 36% saw little benefit.
    • Early positive response to TCAs predicted continued improvement.

    Conclusions:

    • Tricyclic antidepressants demonstrate superior remission rates for geriatric depression compared to psychotherapy.
    • Early response to TCAs is a reliable indicator of treatment efficacy in elderly patients.
    • Further research into optimizing TCA treatment for geriatric depression is warranted.