Depressed Elderly Need Ongoing Care

Many older patients will relapse after treatment ends, study finds

By E.J. Mundell
HealthDay Reporter

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WEDNESDAY, March 15 (HealthDay News) -- The longest study of its kind finds that medical treatment of depression in the elderly may not be a short-term proposition.

That's because depression tended to return after older patients completed the six-to-12-month course of antidepressants psychiatrists typically give to people suffering from the illness, researchers report in the March 16 issue of the New England Journal of Medicine.

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Short-term antidepressant therapy is "really not good enough" when it comes to treating many elderly patients, said lead researcher Dr. Charles F. Reynolds III, a professor of geriatric psychiatry at the University of Pittsburgh School of Medicine.

Instead, he said, "people need to be offered antidepressant medication for at least two years beyond the end of the episode in order to stay well."

The study was funded by grants from the U.S. National Institute for Mental Health and the National Center for Minority Health and Health Disparities.

Reynolds said depression among the elderly is "a major public health problem in a graying America." Up to 10 percent of elderly people living in the community may be afflicted with the illness, he said, and that number rises to 25 percent among nursing-home residents. While depression is linked to physical ailments, the two are not always connected, Reynolds said.

Treatment of a first episode of depression usually involves an antidepressant -- typically one of the selective serotonin reuptake inhibitor (SSRI) class of drugs that includes Celexa, Paxil, Prozac and Zoloft, among others. Patients are usually placed on one of these drugs for between six months to a year.

Reynold's group tested the long-term effectiveness of this strategy, as well as a non-drug approach, psychotherapy, in a group of 116 patients over 70 years of age. The researchers tracked the mental health of participants for two years after the onset of depression. More than half (55 percent) had consulted their doctors after experiencing their first-ever bout of depression.

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