Open-trial maintenance pharmacotherapy in late-life depression: survival analysis

Psychiatry Research
C F ReynoldsD J Kupfer

Abstract

We report preliminary findings from an ongoing, open trial of maintenance nortriptyline pharmacotherapy in 27 elderly depressed patients (median trial length: 18 months). While patients were on maintenance nortriptyline (mean dose: 50 mg/day) with steady-state plasma levels in the range of 50-150 ng/ml, 58% of Q-6 monthly ratings on the Hamilton Rating Scale for Depression have been 10 or lower, Folstein Mini-Mental State ratings have remained above 27, and a minimal level of side effects with no increase over time has been observed. Four of 27 patients (14.8%) have suffered recurrences and have required rehospitalization at 6, 9, 10, and 13 months. Survival analysis showed an 85% survival rate (without recurrence) at 12 months and 81.5% at 18 months. Mean survival time without recurrence is 21.3 months to date. Although our pilot experience with maintenance nortriptyline in late-life depression appears more favorable than outcomes reported in earlier naturalistic studies (where no attempt was made to keep patients in systematic maintenance therapy), the need for controlled studies of maintenance therapies in late-life depression is nonetheless underscored by the current data and other naturalistic data from the United Kingdom.

References

Jul 1, 1976·Pharmakopsychiatrie, Neuro-Psychopharmakologie· Kragh-SørensenE F Hvidberg
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Citations

Nov 28, 2002·Progress in Neuro-psychopharmacology & Biological Psychiatry·Giovanni Andrea FavaNicoletta Sonino
Jul 6, 2014·Drugs & Aging·Breno S Diniz, Charles F Reynolds
Dec 19, 1994·The American Journal of Medicine·C F Reynolds
Jul 1, 1992·Journal of the American Geriatrics Society·P V Rabins
Oct 1, 1990·Journal of Geriatric Psychiatry and Neurology·B G PollockC F Reynolds
May 8, 2002·International Journal of Geriatric Psychiatry·Martin M EversDeborah B Marin
Jul 6, 2000·European Psychiatry : the Journal of the Association of European Psychiatrists·R HeunU Ptok
Jun 1, 1997·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·K Rabheru, E Persad
Oct 1, 1994·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·A J Flint

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