|
| | |
|
Am J Psychiatry 1992; 149:1687-1692
Copyright © 1992 by American Psychiatric Association
Combined pharmacotherapy and psychotherapy in the acute and continuation treatment of elderly patients with recurrent major depression: a preliminary report
CF Reynolds 3d, E Frank, JM Perel, SD Imber, C Cornes, RK Morycz, S Mazumdar, MD Miller, BG Pollock and AH Rifai
Department of Psychiatry, University of Pittsburgh School of Medicine, PA.
OBJECTIVE: The authors examined the rate of response to the combination of
nortriptyline and interpersonal psychotherapy for acute and continuation
treatment of elderly patients with recurrent major depression. METHOD: The
subjects were 73 elderly patients, 61 of whom completed treatment.
Nortriptyline steady-state blood levels were maintained at 80-120 ng/ml,
and interpersonal psychotherapy was administered weekly for 9.1 weeks
(medium) of acute therapy and was decreased from biweekly to triweekly
during 16 weeks of continuation therapy. During acute treatment
nonresponding patients also received brief adjunctive pharmacotherapy with
lithium or perphenazine. RESULTS: Of the 61 subjects given adequate trials
of nortriptyline and interpersonal psychotherapy, 48 (78.7%) achieved full
remission (Hamilton depression rating of 10 or lower over 16 weeks of
continuation therapy), 10 patients (16.4%) did not respond (Hamilton rating
never below 15), and three achieved only partial remission (Hamilton rating
of 11-14). Early versus late onset was not associated with a difference in
response rate. During the placebo-controlled, double-blind transition to
maintenance therapy, 19 (76.0%) of the 25 patients randomly assigned to
placebo maintenance conditions showed continued recovery and six relapsed.
None of the 24 patients assigned to nortriptyline conditions relapsed.
CONCLUSIONS: Use of nortriptyline plus interpersonal psychotherapy for 9.1
weeks (median) of acute and 16 weeks of continuation therapy appears to be
associated with good response and relatively low attrition but about a 25%
chance of relapse during double-blind discontinuation of nortriptyline.
These data require confirmation in a controlled clinical trial of acute and
continuation therapy.
This article has been cited by other articles:
|
|
|
|
 
C. L. Turvey and D. M. Klein
Remission From Depression Comorbid With Chronic Illness and Physical Impairment
Am J Psychiatry,
May 1, 2008;
165(5):
569 - 574.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Heo, C. F. Murphy, and B. S. Meyers
Relationship Between the Hamilton Depression Rating Scale and the Montgomery-Asberg Depression Rating Scale in Depressed Elderly: A Meta-analysis
Am J Geriatr Psychiatry,
October 1, 2007;
15(10):
899 - 905.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. B. Keller
Past, Present, and Future Directions for Defining Optimal Treatment Outcome in Depression: Remission and Beyond
JAMA,
June 18, 2003;
289(23):
3152 - 3160.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. G. Blazer
Depression in Late Life: Review and Commentary
J. Gerontol. A Biol. Sci. Med. Sci.,
March 1, 2003;
58(3):
M249 - 265.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. E. Keck Jr., S. L. McElroy, S. M. Strakowski, S. A. West, K. W. Sax, J. M. Hawkins, M. L. Bourne, and P. Haggard
12-Month Outcome of Patients With Bipolar Disorder Following Hospitalization for a Manic or Mixed Episode
Focus,
January 1, 2003;
1(1):
44 - 52.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. J. Klausner and G. S. Alexopoulos
The Future of Psychosocial Treatments for Elderly Patients
Psychiatr Serv,
September 1, 1999;
50(9):
1198 - 1204.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. D. Green, C. F. Reynolds III, B. H. Mulsant, B. G. Pollock, M. D. Miller, P. R. Houck, S. Mazumdar, M. A. Dew, and D. J. Kupfer
Accelerating Antidepressant Response in Geriatric Depression: A Post Hoc Comparison of Combined Sleep Deprivation and Paroxetine versus Monotherapy with Paroxetine, Nortriptyline, or Placebo
J Geriatr Psychiatry Neurol,
July 1, 1999;
12(2):
67 - 71.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. V. Prochazka, M. J. Weaver, R. T. Keller, G. E. Fryer, P. A. Licari, and D. Lofaso
A Randomized Trial of Nortriptyline for Smoking Cessation
Arch Intern Med,
October 12, 1998;
158(18):
2035 - 2039.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. DasGupta
Treatment of Depression in Elderly Patients: Recent Advances
Arch Fam Med,
June 1, 1998;
7(3):
274 - 280.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. E. Keck Jr., S. L. McElroy, S. M. Strakowski, S. A. West, K. W. Sax, J. M. Hawkins, M. L. Bourne, and P. Haggard
12-Month Outcome of Patients With Bipolar Disorder Following Hospitalization for a Manic or Mixed Episode
Am J Psychiatry,
May 1, 1998;
155(5):
646 - 652.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M. D. Miller, E. I. Curtiss, L. Marino, P. R. Houck, C. F. Paradis, S. Mazumdar, B. G. Pollock, J. Foglia, and C. F. Reynolds III
Long-Term ECG Changes in Depressed Elderly Patients Treated With Nortriptyline: A Double-Blind, Randomized, Placebo-Controlled Evaluation
Am J Geriatr Psychiatry,
February 1, 1998;
6(1):
59 - 66.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. M. Strakowski, P. E. Keck Jr, S. L. McElroy, S. A. West, K. W. Sax, J. M. Hawkins, G. F. Kmetz, V. H. Upadhyaya, K. C. Tugrul, and M. L. Bourne
Twelve-Month Outcome After a First Hospitalization for Affective Psychosis
Arch Gen Psychiatry,
January 1, 1998;
55(1):
49 - 55.
[Abstract]
[Full Text]
[PDF]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 1992
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
