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How Long Should the Elderly Take Antidepressants?

A Double-Blind Placebo-Controlled Study of Continuation/Prophylaxis Therapy with Dothiepin

Published online by Cambridge University Press:  02 January 2018

Robin Jacoby ,
A. Daniel Lunn ,
M. Ardern ,
K. Bergmann ,
J. Conway ,
N. Cooling ,
G. Davies ,
J. Fisk ,
E. Gehlhaar  and
P. Harrison-Read
...Show all authors
Robin Jacoby*
Affiliation:
The Maudsley Hospital, London SE5 8AZ
A. Daniel Lunn
Affiliation:
The Open University & Worcester College, Oxford OX1 2HB
M. Ardern
Affiliation:
London
K. Bergmann
Affiliation:
London
J. Conway
Affiliation:
Sheffield
N. Cooling
Affiliation:
Norwich
G. Davies
Affiliation:
Oxford
J. Fisk
Affiliation:
Keighley
E. Gehlhaar
Affiliation:
London
P. Harrison-Read
Affiliation:
London
R. Jacoby
Affiliation:
London
R. Jones
Affiliation:
Nottingham
R. Levy
Affiliation:
London
A. MacDonald
Affiliation:
London
M. Naguib
Affiliation:
London
C. Oppenheimer
Affiliation:
Oxford
M. Philpot
Affiliation:
London
R. Philpott
Affiliation:
Liverpool
B. Pitt
Affiliation:
London
M. Price
Affiliation:
Plymouth
J. Robinson
Affiliation:
Oxford
M. Silverman
Affiliation:
London
Z. Slattery
Affiliation:
Bury St Edmunds
C. Staley
Affiliation:
Norwich
E. Taws
Affiliation:
Norwich
E. Tym
Affiliation:
Cambridge
*
∗Correspondence
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Abstract

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.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 2 , February 1993 , pp. 175 - 182
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

Ames, D. & Allen, N. (1991) The prognosis of depression in old age: good, bad or indifferent? International Journal of Geriatric Psychiatry, 6, 477–481.CrossRefGoogle Scholar
Baldwin, R. C. & Jolley, D. J. (1986) The prognosis of depression in old age. British Journal of Psychiatry, 149, 574–583.CrossRefGoogle ScholarPubMed
Cole, M. G. (1990) The prognosis of depression in the elderly. Canadian Medical Association Journal, 143, 633–639.Google Scholar
Cook, B. L., Helms, P. M., Smith, R. E., et al (1986) Unipolar depression in the elderly: reoccurrence on discontinuation of tricyclic antidepressants. Journal of Affective Disorders, 10, 91–94.Google Scholar
Cox, D. R. & Oakes, D. (1984) Analysis of Survival Data. London: Chapman & Hall.Google Scholar
Efron, B. (1977) The efficiency of Cox's likelihood function for censored data. Journal of the American Statistical Association, 72, 557–565.CrossRefGoogle Scholar
Frank, E., Kupfer, D. J., Perel, J. M., et al (1990) 3-year outcomes for maintenance therapies in recurrent depression. Archives of General Psychiatry, 47, 1093–1099.Google Scholar
Georgeotas, A., McCue, R. E. & Cooper, T. B. (1989) A placebo-controlled comparison of nortriptyline and phenelzine in maintenance therapy of elderly depressed patients. Archives of General Psychiatry, 46, 783–786.Google Scholar
Glen, A. I. M., Johnson, A. L. & Shepherd, M. (1984) Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a randomised, double-blind, controlled trial. Psychological Medicine, 14, 37–50.Google Scholar
Hodkinson, H. M. (1973) Mental impairment in the elderly. Journal of the Royal College of Physicians of London, 7, 305–317.Google ScholarPubMed
Kay, D. W. K., Fahy, T. & Garside, R. F. (1970) A seven-month double-blind trial of amitriptyline and diazepam in ECT-treated depressed patients. British Journal of Psychiatry, 117, 667–671.Google Scholar
Lee, A. S. & Murray, R. M. (1988) The long-term outcome of Maudsley depressives. British Journal of Psychiatry, 153, 741–751.Google Scholar
Lunn, A. D. & McNeil, D. R. (1991) Computer Interactive Data Analysis. Chichester: Wiley.Google Scholar
McCullagh, P. (1980) Regression models for ordinal data. Journal of the Royal Statistical Society B, 42, 109–142.Google Scholar
Mindham, R. H. S., Howland, O. & Shepherd, M. (1973) An evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychological Medicine, 3, 5–17.CrossRefGoogle ScholarPubMed
Montgomery, S. A. (1990) The choice of long term treatment of depression depends on evidence of long term efficacy. In Current Approaches: Prediction and Treatment of Recurrent Depression (eds Cobb, J. & Goeting, N. L. M.). Southampton: Duphar Laboratories.Google Scholar
Montgomery, S. A. & Asberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.Google Scholar
Murphy, E. (1983) The prognosis of depression in old age. British Journal of Psychiatry, 142, 111–119.CrossRefGoogle ScholarPubMed
Murphy, E. (1987) The prognosis of depression in old age. British Journal of Psychiatry, 150, 268.Google Scholar
Norusis, M. J. (1988) SPSS/PC. Chicago: SPSS Inc.Google Scholar
O'Neill, C. J. A., Dobbs, R. J., Dobbs, S. M., et al (1991) Measurement of compliance with medication: the sine qua non of clinical trials in old age? Age and Ageing, 20, 77–79.Google Scholar
Post, F. (1972) The management and nature of depressive illness in late life: a follow-through study. British Journal of Psychiatry, 121, 393–404.Google Scholar
Prien, R. F., Klett, C. J. & Caffey, E. M. (1973) Lithium carbonate and imipramine in prevention of affective episodes. Archives of General Psychiatry, 29, 420–425.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Stein, M. K., Rickels, K. & Weise, C. C. (1980) Maintenance therapy with amitriptyline: a controlled trial. American Journal of Psychiatry, 137, 370–371.Google Scholar
World Health Organization Mental Health Collaborating Centres (1989) Pharmacotherapy of depressive disorders: a consensus statement. Journal of Affective Disorders, 17, 197–198.CrossRefGoogle Scholar
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