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Comparison of Desipramine and Cognitive/Behavioral Therapy in the Treatment of Elderly Outpatients With Mild-to-Moderate Depression

Received September 13, 1999; revised July 6, 2000; accepted August 21, 2000. From the Geriatric Research, Education and Clinical Center (GRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, and the Dept. of Medicine, Stanford University School of Medicine, Stanford, CA. Address correspondence to Dr. Thompson, Pacific Graduate School of Psychology, 935 East Meadow, Palo Alto, CA 94304. e-mail: larrywt{at}leland.stanford.edu

The authors evaluated the efficacy of desipramine-alone, vs. cognitive/behavioral therapy-alone (CBT) vs. a combination of the two, for the treatment of depression in older adult outpatients. Patients (N=102) meeting criteria for major depressive disorder were randomly assigned to one of these three treatments for 16 to 20 therapy sessions. All treatments resulted in substantial improvement. In general, the CBT-Alone and Combined groups had similar levels of improvement. In most analyses, the Combined group showed greater improvement than the Desipramine-Alone group, whereas the CBT-Alone group showed only marginally better improvement. The combined therapies were most effective in patients who were more severely depressed, particularly when desipramine was at or above recommended stable dosage levels. The results indicate that psychotherapy can be an effective treatment for older adult outpatients with moderate levels of depression.

Key Words: Depression • Antidepressants • Cognitive/Behavioral Therapy

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