Placebo-controlled treatment trial of depression in elderlyphysically ill patients
M. Evans
Bok Engelsk 1997
| Utgitt | 1997
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| Omfang | 7 s.
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| Opplysninger | Objectives. To determine the response of physically ill elderly depressed patients to treatment.Design. Acute geriatric medical inpatients with depression, randomly assigned to an 8-week double-blind placebo-controlled trial of fluoxetine.Main outcome measure. Response rate as defined by the 17-item Hamilton Depression Rating Scale.Results. Eighty-two patients entered the trial; 62 patients (all those who had completed at least 3 weeks of treatment) were included in the efficacy analysis. Forty-two completed the full 8 weeks (21 in each group) with response rates of 67% in the fluoxetine group and38% in the placebo group. No significant difference was found between the responses of the two groups (p = 0.12). There was a trend for results in the fluoxetine group to continue to improve with time. On secondary analysis those patients with serious physical illness who completed 5 or more weeks (N = 37) showed a significant improvement in mood if treated with fluoxetine (p = 0.02).Conclusions. The main benefit of antidepressants is to approximately double the chances of recovery. This trial showed the response rate of the fluoxetine treated group was increased by a factor of 1.8 over the placebo group in an 8-week period. The presence of physical illness, often severe and/or multiple, did not reduce the effectiveness of the medication, which was well tolerated overall.Those with serious physical disease responded significantly better to drug treatment; this will require further work. Psychological supportwas also considered to be important.
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