USE OF SSRIS IN VERY OLD DEPRESSED NURSING-HOME RESIDENTS

The authors examined 50 patients, with a mean age of 89 years (range: 80-98), placed in a prospective, open-label trial of either fluoxetine , sertraline, or paroxetine. At 12-week follow-up, there was a signifi cant overall decline (36%) in Ham-D scores; 42% had at least a 50% dec line in their scores. There were no significant differences in respons es to the three antidepressants, and all drugs were well tolerated. Ho wever, there were significant differences between diagnostic subgroups in the percentage of persons showing at least a 50% decrease in their Ham-D scores: major depressive disorder (MDD; 93%), Alzheimer's disea se with MDD (8%), vascular dementia with MDD (6%), and other CNS-relat ed disorders with MDD (83%). The findings confirm earlier accounts tha t antidepressants may be substantially less effective with MDD seconda ry to dementia in very old patients.