Placebo-controlled treatment trial of depression in elderly physically ill patients

Evans, Mdr; Hammond, Margaret; Wilson, Kenneth; Lye, Michael; Copeland, J. R. M.

doi:10.1002/(sici)1099-1166(199708)12:8<817::aid-gps645>3.0.co;2-4

Cited by 91 publications

(59 citation statements)

References 40 publications

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“…Two of five (40%) studies with an entry age of 55, investigating a total of 70 subjects, reported negative results (Jarvik et al, 1982;Kane et al, 1983). In contrast, three of 12 studies (17%) with a minimum entry age of 60, investigating a total of 709 subjects, reported negative results on their primary outcome (Tan et al, 1994;Tollefson et al, 1995;Evans et al, 1997). One of these reported positive results on secondary outcomes (Tollefson et al, 1995).…”

Section: Methodological Considerations For Antidepressant Trials In Tmentioning

confidence: 97%

“…One of these reported positive results on secondary outcomes (Tollefson et al, 1995). One of the three studies with a minimum inclusion age of 65 reported negative results (Evans et al, 1997), but this was in a population with significant medical comorbidity. It is difficult to draw any firm conclusions from these results.…”

Section: Methodological Considerations For Antidepressant Trials In Tmentioning

confidence: 98%

“…The two studies in medical in-patients both failed to differentiate active drug from placebo (Tan et al, 1994;Evans et al, 1997). The two studies in nursing home populations found differing results (Katz et al, 1990;Burrows et al, 2002), but this was complicated as one examined minor rather than major depression (Burrows et al, 2002).…”

Section: Methodological Considerations For Antidepressant Trials In Tmentioning

confidence: 99%

“…An early trial found that fluvoxamine and imipramine were both superior to placebo (Wakelin, 1986). Another study in medical in-patients (Evans et al, 1997) found no significant difference in treatment response between subjects receiving fluoxetine and placebo. This study examined a small population of older medically ill subjects; either of these factors may have contributed toward the negative outcome.…”

Section: Selective Serotonin Reuptake Inhibitorsmentioning

confidence: 99%

“…More studies reported outcomes of improved on CGI-I (Kane et al, 1983;Cohn et al, 1984;Merideth et al, 1984;Katz et al, 1990;Nair et al, 1995;Tollefson et al, 1995;Schweizer et al, 1998;Schneider et al, 2003) than outcomes of response or remission on HAM-D (Nair et al, 1995;Tollefson et al, 1995;Evans et al, 1997;Schweizer et al, 1998;Schneider et al, 2003). We did not include the study of minor depression (Burrows et al, 2002) in these analyses.…”

Section: Number Needed To Treat Analysesmentioning

confidence: 99%

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A Systematic Review of Antidepressant Placebo-Controlled Trials for Geriatric Depression: Limitations of Current Data and Directions for the Future

Taylor

Doraiswamy

2004

Neuropsychopharmacol

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Depression in the elderly is a major public health problem as untreated depression adversely impacts comorbid illnesses. It is important to develop safe and effective antidepressant therapies for older individuals. We performed a systematic review of all published randomized, placebo-controlled antidepressant medication trials in populations over age 55 years. Papers were obtained via MEDLINE (1966( -August 2003 and PSYCINFO (1872-August 2003. Unpublished trials, trials examining nonpharmacologic interventions, and papers reporting post hoc analyses were not included in this review unless they provided new insights. A total of 18 placebo-controlled trials examining acute efficacy met our criteria. The combined sample size in these studies was 2252. The mean sample size was 51 (range 20-728) and mean trial duration was 7 weeks. A total of 12 trials examined tricyclic antidepressants (TCAs), five trials examined selective serotonin reuptake inhibitors (SSRIs), two trials examined bupropion, and one trial examined mirtazapine. There were no published trials of venlafaxine or nefazodone. In all, 71.5% of trials reported significantly greater efficacy with drug than placebo. In conclusions, there is a paucity of published controlled antidepressant trials in the elderly. Most published studies examine small sample sizes and do not include common comorbid conditions. Efficacy studies examining relapse prevention are lacking. Large placebo response rates, lack of controlled head to head comparisons, and other methodological design differences make crosstrial comparisons difficult. Large simple studies are urgently needed to address the unmet needs for data on safety and efficacy of antidepressants in this population.

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Section: Methodological Considerations For Antidepressant Trials In Tmentioning

confidence: 97%

Section: Methodological Considerations For Antidepressant Trials In Tmentioning

confidence: 98%

Section: Methodological Considerations For Antidepressant Trials In Tmentioning

confidence: 99%

Section: Selective Serotonin Reuptake Inhibitorsmentioning

confidence: 99%

Section: Number Needed To Treat Analysesmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of Antidepressant Placebo-Controlled Trials for Geriatric Depression: Limitations of Current Data and Directions for the Future

Taylor

Doraiswamy

2004

Neuropsychopharmacol

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Depressive Symptoms and Chronic Obstructive Pulmonary Disease

Niti²,

Tan³

et al. 2007

Arch Intern Med

546

198

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Background: Depressive symptoms are common among patients with chronic obstructive pulmonary disease (COPD), but depression's impact on COPD outcomes has not been fully investigated. We evaluated the impact of comorbid depression on mortality, hospital readmission, smoking behavior, respiratory symptom burden, and physical and social functioning in patients with COPD. Methods: In this prospective cohort study, 376 consecutive patients with COPD hospitalized for acute exacerbation were followed up for 1 year. The independent associations of baseline comorbid depression (designated as a Hospital Anxiety and Depression Scale score of Ն8) with mortality, hospital readmission, length of stay, persistent smoking, and quality of life (determined by responses to the St George Respiratory Questionnaire) were evaluated after adjusting for potential confounders. Results: The prevalence of depression at admission was 44.4%. The median follow-up duration was 369 days, during which 57 patients (15.2%) died, and 202 (53.7%) were

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A 60-Year-Old Woman Who Has Felt Sad for Much of Her Life

Salzman¹

2006

JAMA

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Placebo-controlled treatment trial of depression in elderly physically ill patients

Cited by 91 publications

References 40 publications

A Systematic Review of Antidepressant Placebo-Controlled Trials for Geriatric Depression: Limitations of Current Data and Directions for the Future

A Systematic Review of Antidepressant Placebo-Controlled Trials for Geriatric Depression: Limitations of Current Data and Directions for the Future

Depressive Symptoms and Chronic Obstructive Pulmonary Disease

A 60-Year-Old Woman Who Has Felt Sad for Much of Her Life

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