Aj. Flint et Sl. Rifat, ANXIOUS DEPRESSION IN ELDERLY PATIENTS - RESPONSE TO ANTIDEPRESSANT TREATMENT, The American journal of geriatric psychiatry, 5(2), 1997, pp. 107-115
The authors asked whether elderly patients with anxious depression wer
e less responsive to antidepressant treatment than nonanxious depresse
d patients, A group of 101 depressed patients were treated with 6 week
s of nortriptyline and then, if necessary, 2 weeks of adjunctive lithi
um. Patients who did not respond to or were intolerant of this first l
ine of treatment were then given 6 weeks of phenelzine (+/- lithium au
gmentation). Finally, patients failing this second line of treatment w
ere given either a course of electroconvulsive therapy or 6 weeks of f
luoxetine (+/- lithium augmentation). Based on their score on the Hosp
ital Anxiety and Depression Scale at index assessment, subjects were d
ivided into anxious and nonanxious groups. Anxious depressed patients
were significantly less responsive to nortriptyline on both intent-to-
treat and efficacy analyses. They were also more likely to discontinue
treatment and, as a result, were significantly less responsive on the
intent-to-treat analysis for overall treatment. These results suggest
that concurrent symptoms of anxiety have prognostic importance in ger
iatric depression.