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The Art of Clinical Management in Pharmacologic Trials With Depressed Elderly Patients

Lessons from the Pittsburgh Study of Maintenance Therapies in Late-Life Depression

Received October 28, 1997; accepted May 26, 1998. From the Intervention Research Center for the Study of Late-Life Mood Disorders, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine. Address correspondence to Dr. Miller at Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Room 744 Bellefield Towers, Pittsburgh, PA 15213.

The authors outline the clinical management methods used in a long-term study of depressed elderly patients and comment on the positive aspects of such interventions on the successful recruitment and retention of subjects. Psychosocial or clinical management (CM) is the "glue" that holds a successful drug trial together. CM is recognized to be an essential element for success in drug trials for geriatric depression. The authors also discuss potentially negative aspects of comprehensive CM, such as those obscuring a psychotherapeutic effect in comparative studies.

Key Words: Depression • Antidepressants • Clinical Trials

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