Depression Clinical Trial
Official title:
Geriatric Depression: Getting Better, Getting Well
This study will determine whether adding interpersonal psychotherapy to treatment with the antidepressant escitalopram will be more effective in reducing symptoms of depression than antidepressant medication alone.
The purpose of this research study is to learn if adding psychotherapy (Interpersonal
Psychotherapy) to antidepressant medication (escitalopram), will be more effective in
reducing lingering symptoms of depression and decreasing the burden of these symptoms, when
initial treatment with just antidepressant medication alone has led to only a partial
response. Participation in the study will last up to 22 weeks.
Because fewer than 50% of elderly depressed patients achieve remission and recovery in
response to first-line antidepressant pharmacotherapy, the majority of patients are left
with significant symptoms and functional impairment, putting them at risk of chronic,
relapsing illness, non-adherence to other medical treatment, suicide, and family caregiver
burden. We will recruit and treat 320 patients with unipolar major depression aged 60 and
older, using clinical management with escitalopram 10 mg/day for six weeks. Patients who are
partial responders to escitalopram plus clinical management will be randomly assigned to 16
weeks of extension therapy with either 20 mg escitalopram plus clinical management or 20 mg
escitalopram plus Interpersonal Psychotherapy (IPT, 16 sessions). Changes over time in
measures of depressive symptoms, hopelessness, suicidal ideation, disability, and family
caregiving burden will be assessed. This study will answer the question of how best to treat
partial responders-by simply extending pharmacotherapy at higher doses, or by also adding
psychotherapy-to remission and recovery.
For information on related studies, please follow these links:
http://clinicaltrials.gov/show/NCT00178035
http://clinicaltrials.gov/show/NCT00178074
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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