Continuation Treatment of Delusional Depression in Older Adults
| Autor: | Michelle Gabriele, Mimi Hamilton, George S. Alexopoulos, Barnett S. Meyers, Sibel Klimstra, Tatsu Kakuma, Fughik Tirumalasetti |
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| Rok vydání: | 2001 |
| Předmět: |
Pediatrics
medicine.medical_specialty Combination therapy medicine.medical_treatment Tardive dyskinesia medicine.disease law.invention Psychiatry and Mental health Pharmacotherapy Randomized controlled trial Extrapyramidal symptoms law medicine Geriatrics and Gerontology medicine.symptom Psychology Psychiatry Adverse effect Antipsychotic Depression (differential diagnoses) |
| Zdroj: | The American Journal of Geriatric Psychiatry. 9:415-422 |
| ISSN: | 1064-7481 |
| DOI: | 10.1097/00019442-200111000-00010 |
| Popis: | Delusional depression responds poorly to acute antidepressant monotherapy but appears to respond to intensive combination pharmacotherapy, however with poor short-term outcomes after initial improvement, particularly in later life. The authors compared the efficacy and safety of continuation combination therapy to monotherapy among older patients after remission from a delusional depression. Twenty-nine older adults with SCID-diagnosed major depression with delusions received continuation treatment with nortriptyline-plus-perphenazine or nortriptyline-plus-placebo under randomized double-blind conditions after achieving remission after ECT. Of the 28 subjects included in efficacy analyses, 25% suffered relapses. The relapse frequency was nonsignificantly greater in combination therapy than in monotherapy subjects. However, combination subjects had significantly more extrapyramidal symptoms, an increased incidence of tardive dyskinesia, and a greater number of falls. Continuation treatment with a conventional antipsychotic does not decrease relapse rates but is associated with significant untoward adverse events in older persons after recovery from a delusional depression. |
| Databáze: | OpenAIRE |
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