OBJECTIVES: More than half of older adults with major depressive disorder require extended treatment because of incomplete response during acute treatment. This study characterizes the effect of anxiety on remission during extended treatment for partial responders. METHODS: Following 6 weeks of escitalopram 10 mg/day+depression care management (DCM), 124 partial responders (Hamilton Rating Scale for Depression (HRSD) scores of 11-14) were randomly assigned to receive extended treatment with escitalopram 20 mg/day+DCM with or without interpersonal psychotherapy (IPT) for 16 weekly sessions. Remission was defined as three consecutive weekly scores <or=7 on the HRSD. We assessed concurrent symptoms of anxiety using the Hamilton Rating Scale for Anxiety at pretreatment and after 6 weeks. We conducted Cox regression analysis of time to remission and logistic modeling of rates of remission. We also explored whether anxiety severity altered any impact of IPT. RESULTS:Pretreatment anxiety was not associated with time to or rates of remission during 16 weeks of extended treatment. In contrast, more severe psychological symptoms of anxiety after 6 weeks of treatment was associated with both longer time to and lower rates of remission. However, there was no evidence that IPT showed any differential effects as a function of anxiety. CONCLUSIONS: In partial responders to 6 weeks of lower-dose escitalopram and DCM, planning for extended treatment should account for psychological symptoms of anxiety.
RCT Entities:
OBJECTIVES: More than half of older adults with major depressive disorder require extended treatment because of incomplete response during acute treatment. This study characterizes the effect of anxiety on remission during extended treatment for partial responders. METHODS: Following 6 weeks of escitalopram 10 mg/day+depression care management (DCM), 124 partial responders (Hamilton Rating Scale for Depression (HRSD) scores of 11-14) were randomly assigned to receive extended treatment with escitalopram 20 mg/day+DCM with or without interpersonal psychotherapy (IPT) for 16 weekly sessions. Remission was defined as three consecutive weekly scores <or=7 on the HRSD. We assessed concurrent symptoms of anxiety using the Hamilton Rating Scale for Anxiety at pretreatment and after 6 weeks. We conducted Cox regression analysis of time to remission and logistic modeling of rates of remission. We also explored whether anxiety severity altered any impact of IPT. RESULTS: Pretreatment anxiety was not associated with time to or rates of remission during 16 weeks of extended treatment. In contrast, more severe psychological symptoms of anxiety after 6 weeks of treatment was associated with both longer time to and lower rates of remission. However, there was no evidence that IPT showed any differential effects as a function of anxiety. CONCLUSIONS: In partial responders to 6 weeks of lower-dose escitalopram and DCM, planning for extended treatment should account for psychological symptoms of anxiety.
Authors: Carmen Andreescu; Eric J Lenze; Mary Amanda Dew; Amy E Begley; Benoit H Mulsant; Alexandre Y Dombrovski; Bruce G Pollock; Jacqueline Stack; Mark D Miller; Charles F Reynolds Journal: Br J Psychiatry Date: 2007-04 Impact factor: 9.319
Authors: Ramin Saghafi; Charlotte Brown; Meryl A Butters; Jill Cyranowski; Mary Amanda Dew; Ellen Frank; Ariel Gildengers; Jordan F Karp; Eric J Lenze; Francis Lotrich; Lynn Martire; Sati Mazumdar; Mark D Miller; Benoit H Mulsant; Elizabeth Weber; Ellen Whyte; Jennifer Morse; Jacqueline Stack; Patricia R Houck; Salem Bensasi; Charles F Reynolds Journal: Int J Geriatr Psychiatry Date: 2007-11 Impact factor: 3.485
Authors: Eric J Lenze; Benoit H Mulsant; M Katherine Shear; Patricia Houck; Charles F Reynolds III Journal: Drugs Aging Date: 2002 Impact factor: 3.923
Authors: Leslie Thomas; Benoit H Mulsant; Francis X Solano; Ann M Black; Salem Bensasi; Tracy Flynn; Jeffrey S Harman; Bruce L Rollman; Edward P Post; Bruce G Pollock; Charles F Reynolds Journal: Am J Geriatr Psychiatry Date: 2002 Sep-Oct Impact factor: 4.105
Authors: Wenjun Li; Yang Wang; B Douglas Ward; Piero G Antuono; Shi-Jiang Li; Joseph S Goveas Journal: J Psychiatr Res Date: 2016-12-12 Impact factor: 4.791
Authors: Erica M Richards; Daniel C Mathews; David A Luckenbaugh; Dawn F Ionescu; Rodrigo Machado-Vieira; Mark J Niciu; Wallace C Duncan; Neal M Nolan; Jose A Franco-Chaves; Thomas Hudzik; Carla Maciag; Shuang Li; Alan Cross; Mark A Smith; Carlos A Zarate Journal: Psychopharmacology (Berl) Date: 2016-01-04 Impact factor: 4.530
Authors: Carlijn Wiersema; Richard C Oude Voshaar; Rob H S van den Brink; Hans Wouters; Peter Verhaak; Hannie C Comijs; Hans W Jeuring Journal: Acta Psychiatr Scand Date: 2022-04-29 Impact factor: 7.734