THE EFFECT OF LOW-DOSE LOFEPRAMINE IN DEPRESSED ELDERLY PATIENTS IN GENERAL MEDICAL WARDS

1 A double-blind randomised controlled trial of the effect of low dose lofepramine (70 mg once daily) against placebo was carried out on dep ressed elderly inpatients on general medical wards for the elderly, co mparing measures of depression and side-effects between the randomised groups. Patients were identified for the study using the Geriatric De pression Scale (GDS) and the Brief Assessment Schedule Depression Card s (BASDEC). 2 Sixty-three subjects were randomised: 46 patients comple ted the entire trial of 28 days treatment. BASDEC and GDS were adminis tered on day 8 post-admission, and depressed patients were randomised double-blind to either low dose lofepramine (70 mg daily) (n = 23) or placebo (n = 23). Assessment of changes in depressive states were made using the Montgomery Asberg Depression Rating Scale (MADRS) on days 8 , 18 and 36 post-admission. 3 Both groups improved by a similar amount during the trial. Lofepramine tended to be more effective than placeb o in those patients who were more depressed (GDS greater-than-or-equal -to 18). On the other hand, subjects who were less depressed (i.e. GDS < 18) improved more on placebo than lofepramine. 4 Low dose lofeprami ne may prove useful in moderately or severely depressed patients treat ed for only 4 weeks. However, low dose lofepramine is not indicated fo r mild (GDS 15-18) depression.