Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-19T01:55:47.415Z Has data issue: false hasContentIssue false
  • English
  • Français

Achieving Long-Term Optimal Outcomes in Geriatric Depression and Anxiety

Published online by Cambridge University Press:  07 November 2014

Benoit H. Mulsant ,
Ellen Whyte ,
Eric J. Lenze ,
Francis Lotrich ,
Jordan F. Karp ,
Bruce G. Pollock  and
Charles F. Reynolds III
Get access Rights & Permissions [Opens in a new window]

Abstract

Depression and anxiety disorders are very common in the elderly. Data accumulated over the past 2 decades have shown that most older patients can tolerate and respond to acute treatment with serotonergic antidepressants, other psychotropic agents, or manual-based psychotherapy. However, outcomes under usual-care conditions remain poor. This review proposes that clinicians may significantly improve the long-term outcomes of their older patients with depression and anxiety by focusing on four key factors: (1) identification and treatment of comorbid conditions; (2) full remission of acute symptoms; (3) education of patients, families, and professional colleagues about the need for long-term treatment; and (4) prevention and management of medication side-effects.

Type
Academic Supplement
Information
CNS Spectrums , Volume 8 , Issue S3: Anxiety and Depression in the Elderly: Implications for Diagnosis and Treatment , December 2003 , pp. 27 - 34
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Lenze, EJ, Mulsant, BH, Shear, MK, et al.Comorbid anxiety disorders in depressed elderly patients. Am J Psychiatry. 2000;5:722–728.CrossRefGoogle Scholar
2.Lenze, EJ, Mulsant, BH, Shear, MK, Houck, P, Reynolds, CF 3rd. Anxiety symptoms in elderly patients with depression: what is the best approach to treatment? Drugs Aging. 2002;10:753–760.CrossRefGoogle Scholar
3.Mulsant, BH, Ganguli, M. Epidemiology and diagnosis of depression in late life. J Clin Psychiatry. 1999;60(suppl 20):9–15.Google ScholarPubMed
4.Mulsant, BH, Pollock, BG. Psychopharmacology. In: Blazer, DG, Steffens, DC, Busse, EW, eds. The American Psychiatric Publishing Textbook of Geriatric Psychiatry. 3rd ed. Washington, DC: American Psychiatric Publishing; 2004:455–485.Google Scholar
5.Bump, GM, Mulsant, BH, Pollock, BG, et al.Paroxetine versus nortriptyline in the continuation and maintenance treatment of depression in the elderly. Depress Anxiety. 2001;1:38–44.3.0.CO;2-7>CrossRefGoogle Scholar
6.Dew, MA, Reynolds, CF 3rd, Mulsant, B, et al.Initial recovery patterns may predict which maintenance therapies for depression will keep older adults well. J Affect Disord. 2001;2:155–166.CrossRefGoogle Scholar
7.Reynolds, CF 3rd, Frank, E, Peril, JM, et al.Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: a randomized controlled trial in patients older than 59 years. JAMA. 1999;1:39–45.CrossRefGoogle Scholar
8.Reynolds, CF 3rd, Peril, JM, Frank, E, et al.Three-year outcomes of maintenance nortriptyline treatment in late-life depression: a study of two fixed plasma levels. Am J Psychiatry. 1999;8:1177–1181.CrossRefGoogle Scholar
9.Walters, G, Reynolds, CF 3rd, Mulsant, BH, Pollock, BG. Continuation and maintenance pharmacotherapy in geriatric depression: an open-trial comparison of paroxetine and nortriptyline in patients older than 70 years. J Clin Psychiatry. 1999;60(suppl 2):21–25.Google ScholarPubMed
10.Harman, JS, Rollman, BL, Hanusa, BH, Lenze, EJ, Shear, MK. Physician office visits of adults for anxiety disorders in the United States, 1985-1998. J Gen Int Med. 2002;3:165–172.CrossRefGoogle Scholar
11.Olfson, M, Marcus, SC, Druss, B, Elinson, L, Tanielian, T, Pincus, HA. National trends in the outpatient treatment of depression. JAMA. 2002;2:203–209.CrossRefGoogle Scholar
12.Pincus, HA, Tanielian, TL, Marcus, SC, et al.Prescribing trends in psychotropic medications: primary care, psychiatry, and other medical specialties. JAMA. 1998;7:526–531.CrossRefGoogle Scholar
13.Harman, JS, Mulsant, BH, Kelleher, KJ, Schulberg, HC, Kupfer, DJ, Reynolds, CF 3rd. Narrowing the gap in treatment of depression Int J Psychiatry Med. 2001;3:239–253.CrossRefGoogle Scholar
14.Brown, C, Schulherg, HC, Madonia, MJ, Shear, MK, Houck, PR. Treatment outcomes for primary care patients with major depression and lifetime anxiety disorders. Am J Psychiatry. 1996;10:1293–1300.Google Scholar
15.Kessler, RC, Berglund, P, Demler, O, et al.National Comorbidity Survey Replication. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;23:3095–3105.CrossRefGoogle Scholar
16.Rost, K, Nutting, P, Smith, J, Elliott, CE, Dickinson, M. Managing depression as a chronic disease: a randomised trial of ongoing treatment in primary care. BMJ. 2002;7370:934.Google Scholar
17.Schulberg, HC, Block, MR, Madonia, MJ, et al.The ‘usual care’ of major depression in primary care practice. Arch Fam Med. 1997;4:334–339.CrossRefGoogle Scholar
18.Unützer, J, Katon, W, Callahan, CM, et al.Depression treatment in a sample of 1,801 depressed older adults in primary care. J Am Geriatr Soc. 2003;4:505–514.CrossRefGoogle Scholar
19.Wang, PS, Berglund, P, Kessler, RC. Recent care of common mental disorders in the United States. J Gen Intern Med. 2000;15:284–292.CrossRefGoogle ScholarPubMed
20.Wells, KB, Katon, W, Rogers, B, Camp, P. Use of minor tranquilizers and antidepressant medications by depressed outpatients: results from the medical outcomes study. Am J Psychiatry. 1994;5:694–700.Google Scholar
21.Wells, KB, Sherbourne, C, Schoenbaum, M, et al.Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial. JAMA. 2000;24:3204.Google Scholar
22.Young, AS, Klap, R, Sherbourne, CD, Wells, KB. The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry. 2001;1:55–61.CrossRefGoogle Scholar
23.Meyers, BS, Sirey, JA, Bruce, M, et al.Predictors of early recovery from major depression among persons admitted to community-based clinics: an observational study. Arch Gen Psychiatry. 2002;8:729–735.CrossRefGoogle Scholar
24.Sirey, JA, Meyers, BS, Bruce, ML, Alexopoulos, GS, Perlick, DA, Raue, P. Predictors of antidepressant prescription and early use among depressed outpatients. Am J Psychiatry. 1999;5:690–696.CrossRefGoogle Scholar
25.Wells, KB, Norquist, G, Benjamin, B, Rogers, W, Kahn, K, Brook, R. Quality of antidepressant medications prescribed at discharge to depressed elderly patients in general medical hospitals before and after prospective payment system. Gen Hosp Psychiatry. 1994;1:4–15.CrossRefGoogle Scholar
26.Evers, MM, Samuels, SC, Lantz, M, Khan, K, Brickman, AM, Marin, DB. The prevalence, diagnosis and treatment of depression in dementia patients in chronic care facilities in the last six months of life. Int J Geriatr Psychiatry. 2002;5:464–472.CrossRefGoogle Scholar
27.Kamath, M, Finkel, SI, Moran, MB. A retrospective chart review of antidepressant use, effectiveness, and adverse effects in adult age 70 and older. Am J Geriatr Psychiatry. 1996;2:167–172.CrossRefGoogle Scholar
28.Luber, MP, Meyers, BS, Williams-Russo, PG, et al.Depression and service utilization in elderly primary care patients. Am J Geriatr Psychiatry. 2001;2:169–176.CrossRefGoogle Scholar
29.Orrell, M, Collins, E, Shergill, S, Katona, C. Management of depression in the elderly by general practitioners: I. Use of antidepressants. Fam Pract. 1995;1:5–11.CrossRefGoogle Scholar
30.Rojas-Fernandez, C, Thomas, VS, Carver, D, Tonks, R. Suboptimal use of antidepressants in the elderly: a population-based study in Nova Scotia. Clin Ther. 1999;11:1937–1950.CrossRefGoogle Scholar
31.Steffens, DC, Skoog, I, Norton, MC, et al.Prevalence of depression and its treatment in an elderly population: the Cache County study. Arch Gen Psychiatry. 2000;6:601–607.CrossRefGoogle Scholar
32.Unützer, J, Patrick, DL, Simon, G, et al.Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA. 1997;20:1618–1623.CrossRefGoogle Scholar
33.Unützer, J, Katon, W, Callahan, CM, et al.IMPACT Investigators. Improving Mood-Promoting Access to Collaborative Treatment. Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA. 2002;22:2836–2845.CrossRefGoogle Scholar
34.Roy-Byrne, PP, Stein, MB, Russo, J, et al.Panic disorder in the primary care setting: comorbidity, disability, service utilization, and treatment. J Clin Psychiatry. 1999;7:492–499.CrossRefGoogle Scholar
35.Andrews, G, Sanderson, K, Slade, T, Issakidis, C. Why does the burden of disease persist? Relating the burden of anxiety and depression to effectiveness of treatment. Bull World Health Org. 2000;4:446–454.Google Scholar
36.Lin, EH, Katon, WJ, Simon, GE, et al.Low-intensity treatment of depression in primary care: is it problematic? Gen Hosp Psychiatry. 2000;2:78–83.CrossRefGoogle Scholar
37.Meyers, BS. Effectiveness vs. efficacy of antidepressants for the treatment of late-life depression: Introduction to a retrospective chart review of antidepressants use, effectiveness, and adverse effects in adults age 70 and older. Am J Geriatr Psychiatry. 1996;2:164–166.CrossRefGoogle Scholar
38.Nutting, PA, Rost, K, Smith, J, Werner, JJ, Elliot, C. Competing demands from physical problems: effect on initiating and completing depression care over 6 months. Arch Fam Med. 2000;10:1059–1064.CrossRefGoogle Scholar
39.Unützer, J, Katon, W, Sullivan, M, Miranda, J. Treating depressed older adults in primary care: narrowing the gap between efficacy and effectiveness. 1999;2:225–256.Google Scholar
40.Rost, K, Nutting, P, Smith, J, Coyne, JC, Cooper-Patrick, L, Rubenstein, L. The role of competing demands in the treatment provided primary care patients with major depression. Arch Fam Med. 2000;2:150–154.CrossRefGoogle Scholar
41.Callahan, CM, Hendrie, HC, Tierney, WM. The recognition and treatment of late-life depression: a view from primary care. Int J Psychiatry Med. 1996;2:155–171.CrossRefGoogle Scholar
42.Zimmerman, M, Mattia, JI, Posternak, MA. Are subjects in pharmacological treatment trials of depression representative of patients in routine clinical practice? Am J Psychiatry. 2002;3:469–473.CrossRefGoogle Scholar
43.Boudreau, DM, Capoccia, KL, Sullivan, SD, et al.Collaborative care model to improve outcomes in major depression. Ann Pharmacother. 2002;4:585–591.CrossRefGoogle Scholar
44.Hedrick, SC, Chaney, EF, Felker, B, et al.Effectiveness of collaborative care depression treatment in Veterans' Affairs primary care. J Gen Int Med. 2003;1:9–16.CrossRefGoogle Scholar
45.Katon, W, Von Korff, M, Lin, E, et al.Collaborative management to achieve depression treatment guidelines. J Clin Psychiatry. 1997;58(suppl 1):20–23.Google ScholarPubMed
46.Katon, W, Von Korff, M, Lin, E, et al.Stepped collaborative care for primary care patients with persistent symptoms of depression: a randomized trial. Arch Gen Psychiatry. 1999;12:1109–1115.CrossRefGoogle Scholar
47.Katon, W, Russo, J, Von Korff, M, et al.Long-term effects of a collaborative care intervention in persistently depressed primary care patients. J Gen Int Med. 2002;10:741–748.CrossRefGoogle Scholar
48.Katzelnick, DJ, Simon, GE, Pearson, SD, et al.Randomized trial of a depression management program in high utilizers of medical care. Arch Fam Med. 2000;4:345–351.CrossRefGoogle Scholar
49.Bodenheimer, T, Wagner, EH, Grumbach, K. Improving primary care for patients with chronic illness. JAMA. 2002;14:1775–1779.CrossRefGoogle Scholar
50.Bodenheimer, T, Wagner, EH, Grumbach, K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002;15:1909–1914.CrossRefGoogle Scholar
51.Ford, DE, Pincus, HA, Unützer, J, Bauer, MS, Gonzalez, JJ, Wells, KB. NIMH Affective Disorders Workgroup. Practice-based interventions. Ment Health Servs Res. 2002;4:199–204.CrossRefGoogle ScholarPubMed
52.Mulsant, BH, Alexopoulos, GS, Reynolds, CF 3rd, et al.The PROSPECT Study Group. Pharmacological treatment of depression in older primary care patients: the PROSPECT algorithm. Int J Geriatr Psychiatry. 2001;6:585–592.CrossRefGoogle Scholar
53.Schulberg, HC, Bryce, C, Chism, K, et al.The PROSPECT Group. Managing late-life depression in primary care practice: a case study of the Health Specialist's role. Int J Geriatr Psychiatry. 2001;6:577–584.CrossRefGoogle Scholar
54.Craske, MG, Roy-Byrne, P, Stein, MB, et al.Treating panic disorder in primary care: a collaborative care intervention. Gen Hosp Psychiatry. 2002;3:148–155.CrossRefGoogle Scholar
55.Katon, WJ, Roy-Byrne, P, Russo, J, Cowley, D. Cost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder. Arch Gen Psychiatry. 2002;12:1098–1104.CrossRefGoogle Scholar
56.Mauksch, LB, Tucker, SM, Karon, WJ, et al.Menral illness, functional impairment, and patient preferences for collaborative care in an uninsured, primary care population. J Fam Pract. 2001;1:41–47.Google Scholar
57.Roy-Byrne, PP, Katon, W, Cowley, DS, Russo, J. A randomized effectiveness trial of collaborative care for patients with panic disorder in primary care. Arch Gen Psychiatry. 2001;9:869–876.CrossRefGoogle Scholar
58.Thomas, L, Mulsant, BH, Solano, FX, et al.Response speed and rate of remission in primary and specialty care of elderly patients with depression. Am J Geriatr Psychiatry. 2002;5:583–591.CrossRefGoogle Scholar
59.Simon, GE, Manning, WG, Katzelnick, DJ, Pearson, SD, Henk, HJ, Helstad, CS. Cost-effectiveness of systematic depression treatment for high utilizers of general medical care. Arch Gen Psychiatry. 2001;2:181–187.CrossRefGoogle Scholar
60.Simon, GE, Von Korff, M, Ludman, EJ, et al.Cost-effectiveness of a program to prevent depression relapse in primary care. Medical Care. 2002;10:941–950.CrossRefGoogle Scholar
61.Von Korff, M, Katon, W, Bush, T, et al.Treatment costs, cost offset, and cost-effectiveness of collaborative management of depression. Psychosom Med. 1998;2:143–149.CrossRefGoogle Scholar
62.Hunkeler, EM, Meresman, JF, Hargreaves, WA, et al.Efficacy of nurse telehealth care and peer support in augmenting treatment of depression in primary care. Arch Fam Med. 2000;8:700–708.CrossRefGoogle Scholar
63.Peveler, R, George, C, Kinmonth, AL, Campbell, M, Thompson, C. Effect of antidepressant drug counseling and information leaflets on adherence to drug treatment in primary care: randomised controlled trial. BMJ. 1999;7210:612–615.CrossRefGoogle Scholar
64.Bartels, SJ, Coakley, E, Oxman, TE, et al.Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use. Am J Geriatr Psychiatry. 2002;4:417–427.CrossRefGoogle Scholar
65.Devanand, DP. Comorbid psychiatric disorders in late life depression. Biol Psychiatry. 2002;3:236–242.CrossRefGoogle Scholar
66.Koike, AK, Unützer, J, Wells, KB. Improving the care for depression in patients with comorbid medical illness. Am J Psychiatry. 2002;10:1738–1745.CrossRefGoogle Scholar
67.Mulsant, BH, Pollock, BG. Treatment-resistant depression in late life. J Geriatr Psychiatry Neurol. 1998;4:186–193.CrossRefGoogle Scholar
68.Oslin, DW, Datto, CJ, Kalian, MJ, et al.Association between medical comorbidity and treatment outcomes in late-life depression. J Am Geriatr Soc. 2002;5:823–828.CrossRefGoogle Scholar
69.Colenda, CC, Mickus, MA, Marcus, SC, Tanielian, TL, Pincus, HA. Comparison of adult and geriatric psychiatric practice patterns: findings from the American Psychiatric Association's Practice Research Network. Am J Geriatr Psychiatry. 2002;5:609–617.CrossRefGoogle Scholar
70.Alexopoulos, GS, Meyers, BS, Young, RC, Mattis, S, Kakuma, T. The course of geriatric depression with “reversible dementia”: a controlled study. Am J Psychiatry. 1993;11:1693–1699.Google Scholar
71.Alexopoulos, GS, Meyers, BS, Young, RC, et al.Executive dys-function and long-term outcomes of geriatric depression. Arch Gen Psychiatry. 2000;3:285–290.CrossRefGoogle Scholar
72.Chen, P, Ganguli, M, Mulsant, BH, DeKosky, ST. The temporal relationship between depressive symptoms and dementia: a community-based prospective study. Arch Gen Psychiatry. 1999;3:261–266.CrossRefGoogle Scholar
73.Oslin, DW, Katz, IR, Edell, WS, Ten Have, TR. Effects of alcohol consumption on the treatment of depression among elderly patients. Am J Geriatr Psychiatry. 2000;3:215–220.CrossRefGoogle Scholar
74.Lopez, OL, Becker, JT, Wisniewski, S, Saxton, J, Kaufer, DI, DeKosky, ST. Cholinesterase inhibitor treatment alters the natural history of Alzheimer's disease. J Neurol Neurosurg Psychiatry. 2002;3:310–314.CrossRefGoogle Scholar
75.Fava, M, Alpert, J, Nierenberg, A, et al.Double-blind study of high-dose fluoxetine versus lithium or desipramine augmentation of fluoxetine in partial responders and nonresponders to fluoxetine. J Clin Psychopharmacol. 2002;4:379–387.CrossRefGoogle Scholar
76.Judd, LL, Paulus, MJ, Schettler, PJ, et al.Does incomplete recovery from first lifetime major depressive episode herald a chronic course of illness? Am J Psychiatry. 2000;9:1501–1504.CrossRefGoogle Scholar
77.Thase, ME, Entsuah, AR, Rudolph, RL. Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors. Br J Psychiatry. 2001;178:234–241.CrossRefGoogle ScholarPubMed
78.Cuffel, BJ, Azocar, F, Tomlin, M, Greenfield, SF, Busch, AB, Croghan, TW. Remission, residual symptoms, and nonresponse in the usual treatment of major depression in managed clinical practice. J Clin Psychiatry. 2003;4:397–402.CrossRefGoogle Scholar
79.Judd, LL, Akiskal, HS, Maser, JD, et al.Major depressive disorder: a prospective study of residual subthreshold depressive symptoms as predictor of rapid relapse. J Affect Disord. 1998;50:97–108.CrossRefGoogle ScholarPubMed
80.Lin, EH, Katon, WJ, VonKorff, M, et al.Relapse of depression in primary care. Rate and clinical predictors. Arch Fam Med. 1998;5:443–449.CrossRefGoogle Scholar
81.Prien, RF, Kupfer, DJ. Continuation drug therapy for major depressive episodes: how long should it be maintained? Am J Psychiatry. 1986;1:18–23.Google Scholar
82.Fava, GA, Grandi, S, Zielezny, M, Rafanelli, C, Canestrari, R. Four-year outcome for cognitive behavioral treatment of residual symptoms in major depression. Randomized controlled trial. Am J Psychiatry. 1996;7:945–947.Google Scholar
83.Taylor, MP, Reynolds, CF 3rd, Frank, E, et al.Which elderly depressed patients remain well on maintenance interpersonal psychotherapy alone?: report from the Pittsburgh study of maintenance therapies in late-life depression. Depress Anxiety. 1999;2:55–60.3.0.CO;2-F>CrossRefGoogle Scholar
84.Thase, ME, Simons, AD, McGeary, J, et al.Relapse after cognitive behavior therapy of depression: potential implications for longer courses of treatment. Am J Psychiatry. 1992;8:1046–1052.Google Scholar
85.Sackeim, HA, Prudic, J, Devanand, DP, Decina, P, Kerr, B, Malitz, S. The impact of medication resistance and continuation pharmacotherapy on relapse following response to electroconvulsive therapy in major depression. J Clin Psychopharmacol. 1990;2:96–104.CrossRefGoogle Scholar
86.Sackeim, HA, Haskett, RF, Mulsant, BH, et al.Continuation pharmacoutherapy in the prevention of relapse following electroconvulsive therapy: a randomized controlled trial. JAMA. 2001;10:1299–1307.CrossRefGoogle Scholar
87.Mulsant, BH, Houck, PH, Gildengers, AG, et al.What is the optimal duration of an acute antidepressant trial when treating geriatric depression? Am J Geriatric Psychiatry. 2002;2(suppl 1):75.Google Scholar
88.Houck, PR, Mazumdar, S, Mulsant, BH, Pollock, BG, Dew, MA, Reynolds, CF 3rd. An intent-to-treat method for enhancing analysis of clinical trials with rescue medication: A mixed model approach. Psychopharmacol Bull. 2003;1:79–89.Google Scholar
89.Opdyke, KS, Reynolds, CF 3rd, Frank, E, et al.Effect of continuation treatment on residual symptoms in late-life depression: how well is “well”? Depress Anxiety. 1997;6:312–319.Google Scholar
90.Buysse, DJ, Reynolds, CF 3rd, Houck, PR, et al.Does lorazepam impair the antidepressant response to nortriptyline and psychotherapy? J Clin Psychiatry. 1997;10:426–432.CrossRefGoogle Scholar
91.Menza, M, Marin, H, Opper, RS. Residual symptoms in depression: can treatment be symptom-specific? J Clin Psychiatry. 2003;5:516–523.CrossRefGoogle Scholar
92.Alexopoulos, GS, Katz, IR, Reynolds, CF, Carpenter, D, Docherty, JP. Pharmacotherapy of depressive disorders in older patients. Expert Consensus Guidelines Series. Postgrad Med. Special Report. 2001.Google Scholar
93.Frank, E, Kupfer, DJ, Perel, JM, et al.Three-year outcomes for maintenance therapies in recurrent depression. Arch Gen Psychiatry. 1990;12:1093–1099.CrossRefGoogle Scholar
94.Perlis, RH, Nierenberg, AA, Alpert, JE, et al.Effects of adding cognitive therapy to fluoxetine dose increase on risk of relapse and residual depressive symptoms in continuation treatment of major depressive disorder. J Clin Psychopharmacol. 2002;5:474–480.CrossRefGoogle Scholar
95.Cramer, JA, Rosenheck, R. Compliance with medication regimens for mental and physical disorders. Psychiatr Serv. 1998;2:196–201.CrossRefGoogle Scholar
96.Kobak, KA, Taylor, L, Katzelnick, DJ, Olson, N, Clagnaz, P, Henk, HJ. Antidepressant medication management and Health Plan Employer Data Information Set (HEDIS) criteria: reasons for nonadherence. J Clin Psychiatry. 2002;8:727–372.CrossRefGoogle Scholar
97.Gilbody, S, Whitty, P, Grimshaw, J, Thomas, R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA. 2003;23:3145–3151.CrossRefGoogle Scholar
98.Oxman, TE, Dietrich, AJ, Williams, JW Jr, Kroenke, K. A three-component model for reengineering systems for the treatment of depression in primary care. Psychosomatics. 2002;6:441–450.CrossRefGoogle Scholar
99.Cruz, M, Pincus, HA. Research on the influence that communication in psychiatric encounters has on treatment. Psychiatr Serv. 2002;10:1253–1265.CrossRefGoogle Scholar
100.Miller, MD, Frank, E, Reynolds, CF 3rd. The art of clinical management in pharmacologic trials with depressed elderly patients: lessons from the Pittsburgh Study of Maintenance Therapies in Late-Life Depression. Am J Geriatr Psychiatry. 1999;3:228–234.CrossRefGoogle Scholar
101.Sherrill, JT, Frank, E, Geary, M, Stack, JA, Reynolds, CF 3rd. Psycho-educational workshops for elderly patients with recurrent major depression and their families. Psychiatr Serv. 1997;1:76–81.Google Scholar
102.Roeloffs, C, Sherbourne, C, Unützer, J, Fink, A, Tang, L, Wells, KB. Stigma and depression among primary care patients. Gen Hosp Psychiatry. 2003;5:311–315.CrossRefGoogle Scholar
103.Sirey, JA, Bruce, ML, Alexopoulos, GS, et al.Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. Am J Psychiatry. 2001;3:479–481.CrossRefGoogle Scholar
104.Lin, EH, Von Korff, M, Katon, W, et al.The role of the primary care physician in patients' adherence to antidepressant therapy. Med Care. 1995;1:67–74.CrossRefGoogle Scholar
105.Bull, SA, Hunkeler, EM, Lee, JY, et al.Discontinuing or switching selective serotonin reuptake inhibitors. Ann Pharmacother. 2002;4:578–584.CrossRefGoogle Scholar
106.Demyttenaere, K, Enzlin, P, Dewe, W, et al.Compliance with antidepressants in a primary care setting, 1: Beyond lack of efficacy and adverse events. J Clin Psychiatry. 2001;62(suppl 22):30–33.Google Scholar
107.Maidment, R, Livingston, G, Katona, C. Just keep taking the tablets: adherence to antidepressant treatment in older people in primary care. Int J Geriatr Psychiatry. 2002;8:752–757.CrossRefGoogle Scholar
108.Depression Guideline Panel. Depression in Primary Care: Vol. 2. Treatment of Major Depression. Rockville, MD: Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; 1993. Clinical Practice Guideline No. 5, publication No. 93-0551.Google Scholar
109.Frank, E, Perel, JM, Mallinger, AG, Thase, ME, Kupfer, DJ. Relationship of pharmacologic compliance to long-term prophylaxis in recurrent depression. Psychopharmacol Bull. 1992;3:231–235.Google Scholar
110.Kupfer, DJ, Frank, E, Perel, JM, et al.Five-year outcome for maintenance therapies in recurrent depression. Arch Gen Psychiatry. 1992;10:769–773.CrossRefGoogle Scholar
111.Reynolds, CF 3rd, Alexopoulos, GS, Katz, IR, Liebowitz, BD. Chronic depression in the elderly: approaches for prevention. Drugs Aging. 2001;7:507–514.CrossRefGoogle Scholar
112.Bull, SA, Hu, XH, Hunkeler, EM, et al.Discontinuation of use and switching of antidepressants: influence of patient-physician communication. JAMA. 2002;11:1403–1409.CrossRefGoogle Scholar
113.Golden, RN, Nemeroff, CB, McSorley, P, Pitts, CD, Dube, EM. Efficacy and tolerability of controlled-release and immediate-release paroxetine in the treatment of depression. J Clin Psychiatry. 2002;7:577–584.CrossRefGoogle Scholar
114.Rapaport, MH, Schneider, LS, Dunner, DL, Davies, JT, Pitts, CD. Efficacy of controlled-release paroxetine in the treatment of late-life depression. J Clin Psychiatry. 2003;64:1065–1074.CrossRefGoogle ScholarPubMed
115.Keller, MB, Hirschfeld, RM, Demyttenaere, K, Baldwin, DS. Optimizing outcomes in depression: focus on antidepressant compliance. Int Clin Psychopharmacol. 2002;6:265–271.CrossRefGoogle Scholar
116.Mulsant, BH, Pollock, BG, Nebes, R, et al.A twelve-week, double-blind, randomized comparison of nortriptyline and paroxetine in older depressed inpatients and outpatients. Am J Geriatr Psychiatry. 2001;4:406–414.CrossRefGoogle Scholar
117.Solai, LK, Mulsant, BH, Pollock, BG. Selective serotonin reuptake inhibitors for late-life depression: a comparative review. Drugs Aging. 2001;5:355–368.CrossRefGoogle Scholar
118.Steffens, DC, Krishnan, KR, Helms, MJ. Are SSRIs better than TCAs? Comparison of SSRIs and TCAs: a meta-analysis. Depress Anxiety. 1997;1:10–18.3.0.CO;2-9>CrossRefGoogle Scholar
119.Thompson, C, Peveler, RC, Stephenson, D, McKendrick, J. Compliance with antidepressant medication in the treatment of major depressive disorder in primary care: a randomized comparison of fluoxetine and a tricyclic antidepressant. Am J Psychiatry. 2000;3:338–343.CrossRefGoogle Scholar
120.Fabian, TJ, Amico, JA, Kroboth, PD, et al.Paroxetine-induced hyponatremia in older adults: a twelve-week prospective study. Arch Int Med. In press.Google Scholar
121.Mulsant, BH, Pollock, BG, Kirshner, M, Shen, C, Dodge, H, Ganguli, M. Serum anticholinergic activity in a community-based sample of older adults: relationship with cognitive performance. Arch Gen Psychiatry. 2003;2:198–203.CrossRefGoogle Scholar
122.Nebes, RD, Pollock, BG, Mulsant, BH, et al.Low-level serum anti-cholinergicity as a source of baseline cognitive heterogeneity in geriatric depressed patients. Psychopharmacol Bull. 1997;4:715–720.Google Scholar
123.Dording, CM, Mischoulon, D, Petersen, TJ, et al.The pharmacologic management of SSRI-induced side effects: a survey of psychiatrists. Ann Clin Psychiatry. 2002;3:143–147.CrossRefGoogle Scholar
124.Fava, M. Management of nonresponse and intolerance: switching strategies. J Clin Psychiatry. 2000;61(suppl 2): 10–12.Google ScholarPubMed
125.Posternak, MA, Zimmerman, M. The effectiveness of switching antidepressants during remission: a case series of depressed patients who experienced intolerable side effects. J Affect Disord. 2002;69:237–240.CrossRefGoogle ScholarPubMed
126.Nierenberg, AA, Adler, LA, Peselow, E, Zornberg, G, Rosenthal, M. Trazodone for antidepressant-associated insomnia. Am J Psychiatry. 1994;7:1069–1072.Google Scholar
127.Nurnberg, HG, Hensley, PL, Gelenberg, AJ, Fava, M, Lauriello, J, Paine, S. Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized controlled trial. JAMA. 2003;1:56–64.CrossRefGoogle Scholar
128.Gitlin, MJ, Suri, R, Altshuler, L, Zuckerbrow-Miller, J, Fairbanks, L. Bupropion-sustained release as a treatment for SSRI-induced sexual side effects. J Sex Marital Ther. 2002;2:131–138.CrossRefGoogle Scholar
129.Kennedy, SH, McCann, SM, Masellis, M, et al.Combining bupropion SR with venlafaxine, paroxetine, or fluoxetine: a preliminary report on pharmacokinetic, therapeutic, and sexual dysfunction effects. J Clin Psychiatry. 2002;3:181–186.CrossRefGoogle Scholar
130.Masand, PS, Ashton, AK, Gupta, S, Frank, B. Sustained-release bupropion for selective serotonin reuptake inhibitor-induced sexual dysfunction: a randomized, double-blind, placebo-controlled, parallel-group study. Am J Psychiatry. 2001;5:805–807.CrossRefGoogle Scholar
131.Joo, JH, Lenze, EJ, Mulsant, BH, et al.Risk factors for falls during treatment of late-life depression. J Clin Psychiatry. 2002;10:936–941.CrossRefGoogle Scholar
132.Pollock, B, Mulsant, BH. Psychopharmacology. In: Crome, P, Ford, G, eds. Drugs and the Older Person. London, England: Imperial College Press; 2000:275–303.Google Scholar
133.Clayton, AH, McGarvey, EL, Abouesh, AI, Pinkerton, RC. Substitution of an SSRI with bupropion sustained release following SSRI-induced sexual dysfunction. J Clin Psychiatry. 2001;3:185–190.CrossRefGoogle Scholar
134.Walker, PW, Cole, JO, Gardner, EA, et al.Improvement in fluoxetine-associated sexual dysfunction in patients switched to bupropion. J Clin Psychiatry. 1993;12:459–465.Google Scholar