The Pharmaceutical Journal
Vol 276 No 7392 p310
18 March 2006

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Maintain SSRIs in the elderly

Recurrence of depression in individuals over 70 years of age can be prevented by maintaining antidepressant treatment, according to the results of a new study (New England Journal of Medicine 2006;354:1130).

Depression can reoccur within two to three years in some 50 to 90 per cent of elderly patients, say the authors. Elderly patients with depression were randomised to receive maintenance paroxetine or placebo, combined with either monthly psychotherapy or clinical-management sessions, for a period of two years or until recurrence of major depression.

The researchers found that paroxetine (along with clinical management) was more effective than monthly psychotherapy (undertaken with placebo) in preventing recurrence of depression (P=0.03).

Over half of enrolled patients (55 per cent) were having their first episode of depression. The authors conclude that their data support the use of selective serotonin reuptake inhibitors — but not interpersonal psychotherapy — in the prevention of depression recurrence in this group of patients.