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Predicting 6‐week treatment response to escitalopram pharmacotherapy in late‐life major depressive disorder
Author(s) -
Saghafi Ramin,
Brown Charlotte,
Butters Meryl A.,
Cyranowski Jill,
Dew Mary Amanda,
Frank Ellen,
Gildengers Ariel,
Karp Jordan F.,
Lenze Eric J.,
Lotrich Francis,
Martire Lynn,
Mazumdar Sati,
Miller Mark D.,
Mulsant Benoit H.,
Weber Elizabeth,
Whyte Ellen,
Morse Jennifer,
Stack Jacqueline,
Houck Patricia R.,
Bensasi Salem,
Reynolds Charles F.
Publication year - 2007
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.1804
Subject(s) - escitalopram , major depressive disorder , anxiety , depression (economics) , psychology , pharmacotherapy , multivariate analysis , psychiatry , partial hospitalization , quality of life (healthcare) , univariate analysis , medicine , mood , mental health , antidepressant , macroeconomics , economics , psychotherapist
Objective Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first‐line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non‐response to escitalopram monotherapy of unipolar MDD in later life. Methods One hundred and seventy‐five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co‐existing medical illness burden, social support, and quality of life (disability). Subjects received 10 mg/d of open‐label escitalopram and were divided into full ( n = 55; 31%), partial ( n = 75; 42.9%), and non‐responder ( n = 45; 25.7%) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups. Results Non‐responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self‐esteem than full responders. In general partial responders resembled full responders more than they resembled non‐responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self‐esteem predicted worse response status at 6 weeks. Conclusion Among treatment‐seeking elderly persons with MDD, higher anxiety symptoms and lower self‐esteem predict poorer response after six weeks of escitalopram treatment. Copyright © 2007 John Wiley & Sons, Ltd.