Nortriptyline and Interpersonal Psychotherapy as Maintenance Therapies for Recurrent Major Depression

Abstract

LD-AGE DEPRESSION IS WIDEspread, affecting at least 1 in 6 patients in general medical practice and an even higher percentage in hospitals and nursing homes. 1-3 Depression, especially in later life, has serious health consequences, including increased health care costs, 4 increased mortality related to suicide 5 and medical illness, 6,7 and amplification of disability associated with medical and cognitive disorders. 8 A recent study by the World Health Organization concluded that unipolar major depression and suicide accounted for 5.1% of the total global burden of disease in 1990, making depression the fourth most important cause of global burden of disability. 9 The study also showed that the significance of illness burden attributable to depression increases with age weighting and is projected to grow further by the year 2020, based on demographic shifts toward a greater proportion of aging adults in the population, especially of the very old.

A feasibility trial of a cognitive-behavioural symptom management program for chronic pelvic pain for men with refractory chronic prostatitis/chronic pelvic pain syndrome

“…Therapy studies have long suggested that maintenance or follow-up sessions are crucial to maintaining positive gains. 27 Future research should examine this therapy within a randomized controlled trial that employs 3-and 6-month follow-up assessments. Such a trial will allow for extensive testing of the risk factor reductions and the associations between changes in patients in a control condition.…”

Evidence-Based Pharmacologic Interventions for Geriatric Depression

“…In a study of treatment for major depression, depressed older adults were randomly assigned to receive nortriptyline, placebo, interpersonal psychotherapy (IPT), or IPT with nortriptyline. In the 3-year follow-up period, the group maintained with combined IPT, and nortriptyline had the lowest recurrence rate (20%) compared with placebo (90%) and was superior in preventing or delaying recurrence [61]. Maintenance treatment is recommended for 12 months after a single episode of depression for older adults and from 1 to 3 years for patients with recurrent depression [62].…”

Tilbakefall etter elektrokonvulsiv terapi

“…In a study on elderly patients who had been successfully treated with antidepressants for recurrent depression, the relapse rate in the course of three years of aftercare was 90 % in those who received a placebo, 64 % in those who received interpersonal psychotherapy plus a placebo, 43 % in those who were given nortriptyline and 20 % in those who received nortriptyline plus interpersonal psychotherapy (2).…”