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Therapeutics
Maintenance treatment with paroxetine, but not psychotherapy, prevented recurrent major depression in older people

https://doi.org/10.1136/ebm.11.4.111

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    Reynolds CF 3rd, Dew MA, Pollock BG, et al. Maintenance treatment of major depression in old age. N Engl J Med 2006;354:1130–8.
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 Q In older patients with major depression who respond to treatment, does maintenance therapy with paroxetine, psychotherapy, or a combination prevent recurrence of depression?

    Clinical impact ratings IM/Ambulatory care ★★★★★★☆ Psychiatry ★★★★★★☆ Geriatrics ★★★★★★☆ GP/FP/Primary care ★★★★★★☆

    METHODS

    Embedded ImageDesign

    randomised, 2 × 2 factorial design, placebo controlled trial.

    Embedded ImageAllocation

    {concealed*}†.

    Embedded ImageBlinding

    blinded (clinicians, patients, and outcome assessors).* Clinicians and patients were not blinded to the psychotherapy intervention.

    Embedded ImageFollow up period

    2 years.

    Embedded ImageSetting

    specialised university-based clinic in Pittsburgh, Pennsylvania, USA.

    Embedded ImagePatients

    116 patients ⩾70 years of age (mean age 77 y, 65% women) who had major depression according to the DSM-IV criteria, score ⩾15 on the Hamilton Rating Scale for Depression (HRSD) (range 0–52 [worst]), score ⩾17 on the Folstein Mini-Mental State Examination (range 0–30 [best]), and a sustained clinical response after several months of treatment with paroxetine, 10–40 mg/day, and …

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    Footnotes

    • ↵* See glossary

    • ↵† Information provided by author.

    • For correspondence: Dr C F Reynolds, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA. reynoldscf{at}upmc.edu

    • Sources of funding: National Institute of Mental Health and National Center for Minority Health and Health Disparities.

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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2006; 11 127-127 Published Online First: 28 Jul 2006. doi: 10.1136/ebm.11.4.127-a