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Two-drug combination helps older adults with depression

Researchers saw a significant improvement in symptoms for patients prescribed an antipsychotic drug after an antidepressant alone did not help them.

By
Stephen Feller
Depression in older adults is often missed by physicians, or is under-treated because a lack of efficacy of antidepressants. Photo by De Visu/Shutterstock
Depression in older adults is often missed by physicians, or is under-treated because a lack of efficacy of antidepressants. Photo by De Visu/Shutterstock

TORONTO, Sept. 28 (UPI) -- Research with younger patients has shown that when an antidepressant alone is not effective at alleviating depression, adding a low dose antipsychotic drug helped to relieve symptoms. A new study found the same to be significantly true with older adults as well.

Non-psychiatric physicians recognize depression in about 1 out of 3 older patients, with many receiving little or no care at all for depression. Researchers add that properly addressing depression in older patients will ease the increased health care they require as a result of not being treated for the condition.

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"It's important to remember that older adults may not respond to medications in the same way as younger adults," said Dr. Eric J. Lenze, director of the Healthy Mind Laboratory at Washington University School of Medicine, in a press release. "There are age-related changes in the brain and body that suggest certain treatments may work differently, in terms of benefits and side effects, in older adults. Even when a strategy works for patients in their 30s, it needs to be tested in patients in their 70s before it can be considered effective in older patients."

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Researchers recruited 468 participants for the study between 2009 and 2013 over than 60 years old who had been diagnosed with depression for a two-stage study.

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The first part of the study saw all the participants randomly treated with venlafaxine, sold as Effexor, or a placebo for 12 weeks. At the conclusion of the first part, about 40 percent of the participants -- 181 patients -- who had not seen remission of their depression symptoms were then placed in the second stage of the study.

The remaining participants whose depression was not alleviated in part one were then randomized to receive venlafaxine either with aripiprazole, sold as Abilify, or a placebo. The two-drug treatment resulted in remission of symptoms in 44 percent of patients, versus 29 percent of those who received the placebo.

Researchers said that not only does the study show that depression treatments can work with older patients, but the two-drug method that has been successful with younger patients also can work with the older ones.

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"This is a rare study because it looks at depression specifically in older adults," said Dr. Benoit Mulsant, a senior scientist at the Center for Addiction and Mental Health. "It's important to treat older adults effectively, especially given that adults with late-life depression are at an increased risk of developing dementia. Our research demonstrates that older adults respond to treatment for depression."

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The study is published in The Lancet.

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