OBJECTIVE: The authors compared the efficacy and side effects of fluoxetine and placebo in elderly outpatients with dysthymic disorder. METHODS: Patients were randomly assigned to fluoxetine (20 mg-60 mg/day) or placebo for 12 weeks in a double-blind trial. RESULTS: Of 90 randomized patients, 71 completed the trial. In the intent-to-treat sample, random regression analyses of the Hamilton Rating Scale for Depression (Ham-D; 24-item) and Cornell Dysthymia Rating Scale (CDRS) scores at each visit produced significant time x treatment group interactions favoring the fluoxetine group. Analysis of percentage change in Ham-D scores yielded no effect for treatment group, but a similar analysis of percentage change in CDRS scores yielded a main effect for treatment group, favoring fluoxetine over placebo. In the intent-to-treat sample, response rates were 27.3% for fluoxetine and 19.6% for placebo. In the completer sample, response rates were 37.5% for fluoxetine and 23.1% for placebo. CONCLUSION:Fluoxetine had limited efficacy in elderly dysthymic patients. The clinical features of elderly dysthymic patients are typically distinct from those of dysthymic disorder in young adults, and the findings suggest that treatments effective for young adult dysthymic patients may not be as useful in elderly dysthymic patients. Further research is needed to identify efficacious treatments for elderly patients with dysthymic disorder, and investigative tools such as electronic/computerized brain scans and neuropsychological testing may help identify the factors that moderate antidepressant treatment response and resistance.
RCT Entities:
OBJECTIVE: The authors compared the efficacy and side effects of fluoxetine and placebo in elderly outpatients with dysthymic disorder. METHODS:Patients were randomly assigned to fluoxetine (20 mg-60 mg/day) or placebo for 12 weeks in a double-blind trial. RESULTS: Of 90 randomized patients, 71 completed the trial. In the intent-to-treat sample, random regression analyses of the Hamilton Rating Scale for Depression (Ham-D; 24-item) and Cornell Dysthymia Rating Scale (CDRS) scores at each visit produced significant time x treatment group interactions favoring the fluoxetine group. Analysis of percentage change in Ham-D scores yielded no effect for treatment group, but a similar analysis of percentage change in CDRS scores yielded a main effect for treatment group, favoring fluoxetine over placebo. In the intent-to-treat sample, response rates were 27.3% for fluoxetine and 19.6% for placebo. In the completer sample, response rates were 37.5% for fluoxetine and 23.1% for placebo. CONCLUSION:Fluoxetine had limited efficacy in elderly dysthymicpatients. The clinical features of elderly dysthymicpatients are typically distinct from those of dysthymic disorder in young adults, and the findings suggest that treatments effective for young adult dysthymicpatients may not be as useful in elderly dysthymicpatients. Further research is needed to identify efficacious treatments for elderly patients with dysthymic disorder, and investigative tools such as electronic/computerized brain scans and neuropsychological testing may help identify the factors that moderate antidepressant treatment response and resistance.
Authors: Gemma Lewis; Larisa Duffy; Anthony Ades; Rebekah Amos; Ricardo Araya; Sally Brabyn; Katherine S Button; Rachel Churchill; Catherine Derrick; Christopher Dowrick; Simon Gilbody; Christopher Fawsitt; William Hollingworth; Vivien Jones; Tony Kendrick; David Kessler; Daphne Kounali; Naila Khan; Paul Lanham; Jodi Pervin; Tim J Peters; Derek Riozzie; George Salaminios; Laura Thomas; Nicky J Welton; Nicola Wiles; Rebecca Woodhouse; Glyn Lewis Journal: Lancet Psychiatry Date: 2019-09-19 Impact factor: 27.083
Authors: Nancy Kerner; Kristina D'Antonio; Gregory H Pelton; Elianny Salcedo; Jennifer Ferrar; Steven P Roose; Dp Devanand Journal: SAGE Open Med Date: 2014-05-08