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Maintenance Treatment for Recurrent Depression in Late Life

A Four-Year Outcome Study

Received December 15, 1998; revised February 10, 1999; accepted April 6, 1999. From the Geriatric Psychiatry Program, The Toronto Hospital and The Toronto Rehabilitation Institute, and the Departments of Psychiatry and Preventive Medicine and Biostatistics, University of Toronto. Address correspondence to Dr. Flint, The Toronto Hospital (General Division), 8 Eaton North, Room 238, 200 Elizabeth St., Toronto, Ontario, M5G 2C4 CANADA. e- mail: alastair.flint{at}uhn.on.ca

The authors examined the 4-year outcome of elderly patients who were given open-label maintenance treatment for recurrent depression. Thirty-eight patients, age 60 years or older, who had recovered from an episode of recurrent nonpsychotic unipolar major depression were maintained on full-dose antidepressant medication and, if necessary, adjunctive lithium. They were followed on a regular basis for 4 years or until recurrence, whichever occurred first. The cumulative probability of remaining well without recurrence was 70%. Longer time to respond to treatment and higher anxiety scores at the time of response predicted shorter time to recurrence.

Key Words: Depression • Outcome Studies • Antidepressants