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Fluoxetine Mildly Effective in Elderly Patients with Dysthymic Disorder: Presented at AAGP

By Bonnie Darves

HONOLULU, HA -- March 7, 2003 -- Elderly patients with dysthymic disorder who take fluoxetine may see only modest improvement in their condition.

Results of a new study conducted by researchers at Columbia University in New York, were presented here March 4^th at the Annual Meeting of the American Association for Geriatric Psychiatry.

The findings are important because few studies have assessed the efficacy of antidepressants in geriatric patients with dysthymia, said lead researcher Devangere Devanand, MD, professor of clinical psychiatry at Columbia University College of Physicians and Surgeons.

Fluoxetine has proved effective in treating younger patients with the disorder, which affects an estimated 3% of the population. But little is known about its efficacy in the elderly population.

A previous study with paroxetine that focused on an elderly population showed moderate benefit for depressive symptoms and mental health function in elderly patients with dysthymia.

In the 12-week, randomised, placebo-controlled trial, 91 outpatients were recruited and 71 completed the study. Forty-four patients were randomly assigned to receive either 20 mg/day to 60 mg/day of fluoxetine and 46 received placebo for 12 weeks.

The researchers used the Hamilton Rating Scale for Depression (HAM-D) and the Cornell Dysthymia Rating Scale (CDRS) to assess patients, with response to treatment defined as a 50% decline in HAM-D score and Clinical Global Impression (CGI) scores of 1 or 2.

In intent-to-treat analyses, response rates were 27.3% for fluoxetine and 19.6% for placebo.

At the end of the trial, patients who received fluoxetine reported improvements in certain quality of life measures, but overall response rates were 37.5% for fluoxetine and 23.1% for placebo. Researchers found, however, that the CDRS was more sensitive than HAM-D in assessing treatment response differences among the patients.

Overall, Dr. Devanand said, the study showed that fluoxetine had limited efficacy in an older population with dysthymia, even though the drug has proved beneficial in younger patients.

He suggested that future research should be conducted to help identify factors that affect antidepressant response in older adults with dysthymia.


[Study title: A Randomized, Placebo-Controlled, Trial Of Fluoxetine Treatment For Elderly Patients With Dysthymic Disorder. Abstract PA-15]

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