HOW COMMON IS RESISTANCE TO TREATMENT IN RECURRENT, NONPSYCHOTIC GERIATRIC DEPRESSION

Effective treatments are available for major depressive disorder in la ter life. The purpose of th is study was to elucidate the frequency of treatment resistance among the elderly. Method: Treatment resistance, defined as lack of recovery despite combined pharmacotherapy and psyc hotherapy, was prospectively examined in 180 elderly patients in an ep isode of recurrent, nonpsychotic major depression who were referred to a university medical center for treatment. They received open acute a nd continuation treatment with nortriptyline and interpersonal psychot herapy. Results: Among the 159 patients who completed acute treatment, 19 (11.9%) did not experience a remission of depression. In addition, nine patients who had achieved remission relapsed during continuation therapy and did not recover despite vigorous treatment. Hence, exclud ing dropouts, 18.4% of the patients met the criteria for treatment res istance by their lack of response to acute treatment or by relapsing d uring continuation therapy and not recovering subsequently despite fur ther vigorous treatment. Conclusions: The study suggests a relatively low rate of resistance to treatment among depressed geriatric patients referred to a university tertiary care setting.