A Comparison of Medication Augmentation and PST in the Treatment of Depression in Older Adults

Major Depressive Disorder Clinical Trial

Official title: A Comparison of Medication Augmentation and Problem Solving Therapy

Status Withdrawn

Clinical Trial Summary

The purpose of this study is to compare the effectiveness of two different augmentation strategies of antidepressant treatment for depressed older adults who have not responded to an adequate trial of antidepressant medication. The first augmentation strategy is Problem Solving Therapy (PST), a 12-week psychotherapy treatment that has been shown to be effective in depressed older adults. The second augmentation strategy is medication augmentation, which will begin with six weeks of aripiprazole, an atypical antipsychotic medication that has also been shown to be effective in depressed older adults who have failed a trial of antidepressant medication.

Clinical Trial Description

Depression is common in older adults, and antidepressant medication is only effective in about 60% of patients seeking treatment. The purpose of this study is to compare the effectiveness of two different augmentation strategies of antidepressant treatment for depressed older adults who have not responded to an adequate trial of antidepressant medication. The first augmentation strategy is Problem Solving Therapy (PST), a 12-week psychotherapy treatment that has been shown to be effective in depressed older adults. The second augmentation strategy is medication augmentation, which will begin with six weeks of aripiprazole, an atypical antipsychotic medication that has also been shown to be effective in depressed older adults who have failed a trial of antidepressant medication. If patients have not remitted at the end of the 6 week aripiprazole trial, the aripiprazole will be stopped and they will be started on bupropion for the remaining 6 weeks of the study. Both aripiprazole augmentation and bupropion augmentation in depressed older adults have been approved by the FDA. No study has compared the effectiveness of PST and medication augmentation strategies for depressed older adults who are non-responders to an adequate trial of antidepressant medication in the current episode of their depression. ;

Related Conditions & MeSH terms

• Depression
• Depressive Disorder
• Depressive Disorder Not Otherwise Specified (NOS)
• Depressive Disorder, Major
• Disease
• Dysthymic Disorder
• Major Depressive Disorder

• NCT number: NCT01942187
• Study type: Interventional
• Source: New York State Psychiatric Institute
• Status: Withdrawn
• Phase: Phase 4
• Start date: August 2013
• Completion date: December 2015