Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder

Ramin Saghafi, Charlotte Brown, Meryl A. Butters, Jill Cyranowski, Mary Amanda Dew, Ellen Frank, Ariel Gildengers, Jordan F. Karp, Eric J. Lenze, Francis Lotrich, Lynn Margaret Martire, Sati Mazumdar, Mark D. Miller, Benoit H. Mulsant, Elizabeth Weber, Ellen Whyte, Jennifer Morse, Jacqueline Stack, Patricia R. Houck, Salem BensasiCharles F. Reynolds

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Abstract

Objective: Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first-line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non-response to escitalopram monotherapy of unipolar MDD in later life. Methods: One hundred and seventy-five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co-existing medical illness burden, social support, and quality of life (disability). Subjects received 10mg/d of open-label escitalopram and were divided into full (n = 55; 31%), partial (n = 75; 42.9%), and non-responder (n = 45; 25.7%) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups. Results: Non-responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self-esteem than full responders. In general partial responders resembled full responders more than they resembled non-responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks. Conclusion: Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment.

Original languageEnglish (US)
Pages (from-to)1141-1146
Number of pages6
JournalInternational Journal of Geriatric Psychiatry
Volume22
Issue number11
DOIs
StatePublished - Nov 1 2007

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Citalopram
Major Depressive Disorder
Self Concept
Anxiety
Drug Therapy
Depression
Cost of Illness
Social Support
Therapeutics
Multivariate Analysis
Quality of Life
Demography
Psychology

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Saghafi, R., Brown, C., Butters, M. A., Cyranowski, J., Dew, M. A., Frank, E., ... Reynolds, C. F. (2007). Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder. International Journal of Geriatric Psychiatry, 22(11), 1141-1146. https://doi.org/10.1002/gps.1804
Saghafi, Ramin ; Brown, Charlotte ; Butters, Meryl A. ; Cyranowski, Jill ; Dew, Mary Amanda ; Frank, Ellen ; Gildengers, Ariel ; Karp, Jordan F. ; Lenze, Eric J. ; Lotrich, Francis ; Martire, Lynn Margaret ; Mazumdar, Sati ; Miller, Mark D. ; Mulsant, Benoit H. ; Weber, Elizabeth ; Whyte, Ellen ; Morse, Jennifer ; Stack, Jacqueline ; Houck, Patricia R. ; Bensasi, Salem ; Reynolds, Charles F. / Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder. In: International Journal of Geriatric Psychiatry. 2007 ; Vol. 22, No. 11. pp. 1141-1146.
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abstract = "Objective: Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first-line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non-response to escitalopram monotherapy of unipolar MDD in later life. Methods: One hundred and seventy-five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co-existing medical illness burden, social support, and quality of life (disability). Subjects received 10mg/d of open-label escitalopram and were divided into full (n = 55; 31{\%}), partial (n = 75; 42.9{\%}), and non-responder (n = 45; 25.7{\%}) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups. Results: Non-responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self-esteem than full responders. In general partial responders resembled full responders more than they resembled non-responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks. Conclusion: Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment.",
author = "Ramin Saghafi and Charlotte Brown and Butters, {Meryl A.} and Jill Cyranowski and Dew, {Mary Amanda} and Ellen Frank and Ariel Gildengers and Karp, {Jordan F.} and Lenze, {Eric J.} and Francis Lotrich and Martire, {Lynn Margaret} and Sati Mazumdar and Miller, {Mark D.} and Mulsant, {Benoit H.} and Elizabeth Weber and Ellen Whyte and Jennifer Morse and Jacqueline Stack and Houck, {Patricia R.} and Salem Bensasi and Reynolds, {Charles F.}",
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Saghafi, R, Brown, C, Butters, MA, Cyranowski, J, Dew, MA, Frank, E, Gildengers, A, Karp, JF, Lenze, EJ, Lotrich, F, Martire, LM, Mazumdar, S, Miller, MD, Mulsant, BH, Weber, E, Whyte, E, Morse, J, Stack, J, Houck, PR, Bensasi, S & Reynolds, CF 2007, 'Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder', International Journal of Geriatric Psychiatry, vol. 22, no. 11, pp. 1141-1146. https://doi.org/10.1002/gps.1804

Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder. / Saghafi, Ramin; Brown, Charlotte; Butters, Meryl A.; Cyranowski, Jill; Dew, Mary Amanda; Frank, Ellen; Gildengers, Ariel; Karp, Jordan F.; Lenze, Eric J.; Lotrich, Francis; Martire, Lynn Margaret; Mazumdar, Sati; Miller, Mark D.; Mulsant, Benoit H.; Weber, Elizabeth; Whyte, Ellen; Morse, Jennifer; Stack, Jacqueline; Houck, Patricia R.; Bensasi, Salem; Reynolds, Charles F.

In: International Journal of Geriatric Psychiatry, Vol. 22, No. 11, 01.11.2007, p. 1141-1146.

Research output: Contribution to journalArticle

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T1 - Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder

AU - Saghafi, Ramin

AU - Brown, Charlotte

AU - Butters, Meryl A.

AU - Cyranowski, Jill

AU - Dew, Mary Amanda

AU - Frank, Ellen

AU - Gildengers, Ariel

AU - Karp, Jordan F.

AU - Lenze, Eric J.

AU - Lotrich, Francis

AU - Martire, Lynn Margaret

AU - Mazumdar, Sati

AU - Miller, Mark D.

AU - Mulsant, Benoit H.

AU - Weber, Elizabeth

AU - Whyte, Ellen

AU - Morse, Jennifer

AU - Stack, Jacqueline

AU - Houck, Patricia R.

AU - Bensasi, Salem

AU - Reynolds, Charles F.

PY - 2007/11/1

Y1 - 2007/11/1

N2 - Objective: Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first-line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non-response to escitalopram monotherapy of unipolar MDD in later life. Methods: One hundred and seventy-five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co-existing medical illness burden, social support, and quality of life (disability). Subjects received 10mg/d of open-label escitalopram and were divided into full (n = 55; 31%), partial (n = 75; 42.9%), and non-responder (n = 45; 25.7%) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups. Results: Non-responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self-esteem than full responders. In general partial responders resembled full responders more than they resembled non-responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks. Conclusion: Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment.

AB - Objective: Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first-line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non-response to escitalopram monotherapy of unipolar MDD in later life. Methods: One hundred and seventy-five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co-existing medical illness burden, social support, and quality of life (disability). Subjects received 10mg/d of open-label escitalopram and were divided into full (n = 55; 31%), partial (n = 75; 42.9%), and non-responder (n = 45; 25.7%) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups. Results: Non-responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self-esteem than full responders. In general partial responders resembled full responders more than they resembled non-responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks. Conclusion: Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment.

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