Aj. Flint et Sl. Rifat, THE EFFECT OF SEQUENTIAL ANTIDEPRESSANT TREATMENT ON GERIATRIC DEPRESSION, Journal of affective disorders, 36(3-4), 1996, pp. 95-105
This study evaluated the outcome of elderly depressed patients who wer
e refractory to, or intolerant of, an initial trial of nortriptyline a
nd who then underwent systematic treatment with other antidepressant t
herapies. 101 patients entered the study and 61% responded to nortript
yline. 64% of patients who did not improve with nortriptyline eventual
ly responded to other antidepressant treatments, Response to second-li
ne treatment (phenelzine) was significantly slower than response to th
e tricyclic antidepressant. Treatment nonresponders were more likely t
o have a longer episode length at index assessment and higher baseline
anxiety scores compared with responders, This study demonstrates the
importance of persisting with systematic antidepressant therapy in eld
erly patients who do not respond to the first trial of treatment.