Effect of Increasing the Dose and Duration of Sertraline Trial in the Treatment of Depressed Nursing Home Residents

• Published in: Journal of geriatric psychiatry and neurology 2003-06, Vol.16 (2), p.109-111
• Main Authors: Weintraub, Daniel, Streim, Joel E., Datto, Catherine J., Katz, Ira R., DiFilippo, Suzanne D., Oslin, David W.
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Aged, 80 and over; Biological and medical sciences; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Male; Medical sciences; Neuropharmacology; Nursing Homes; Pharmacology. Drug treatments; Prevention and actions; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Serotonin Uptake Inhibitors - therapeutic use; Sertraline - therapeutic use; Severity of Illness Index; Specific populations (family, woman, child, elderly...); Surveys and Questionnaires
• ISSN: 0891-9887; 1552-5708
• DOI: 10.1177/0891988703016002008

There has been limited research into defining what constitutes an adequate first-line antidepressant trial in elderly patients. The authors report the outcome of extended, high-dosage sertraline treatment in a sample of nursing home residents experiencing residual significant depressive symptoms after 10 weeks of treatment with sertraline at a final dosage of 100 mg/day. Subjects who had a Hamilton Depression Rating Scale score ≥ 12 after 10 weeks of treatment with sertraline were eligible for the 8-week open-label extension phase, which involved titrating the sertraline dosage to 200 mg/day. The cumulative response rate was 52% for the extension phase, compared with 37% for the acute phase. Examining acute phase nonresponders, 39% responded during the extension phase. Rates of discontinuation due to adverse events were comparable in the 2 phases. Our findings suggest that an extended trial or high dosages of sertraline may benefit some depressed elderly patients with persistent depression after acute treatment. (J Geriatr Psychiatry Neurol 2003; 16:109-111)