Send to:

Choose Destination
See comment in PubMed Commons below
Pain Med. 2012 Mar;13(3):405-18. doi: 10.1111/j.1526-4637.2011.01322.x. Epub 2012 Feb 7.

Addressing both depression and pain in late life: the methodology of the ADAPT study.

Author information

  • 1Departments of Psychiatry, University of Pittsburgh and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.



To describe the methodology of the first NIH-funded clinical trial for seniors with comorbid depression and chronic low back pain.


Randomized controlled effectiveness trial using stepped care methodology. Participants are ≥60 years old. Phase 1 (6 weeks) is open treatment with venlafaxine xr 150 mg/day and supportive management (SM). Response is 2 weeks of PHQ-9 ≤5 and at least 30% improvement in the average numeric rating scale for pain. Nonresponders progress to phase 2 (14 weeks) in which they are randomized to high-dose venlafaxine xr (up to 300 mg/day) with problem solving therapy for depression and pain (PST-DP) or high-dose venlafaxine xr and continued SM. Primary outcomes are the univariate pain and depression response and both observed and self-reported disability. Survival analytic techniques will be used, and the clinical effect size will be estimated with the number needed to treat. We hypothesize that self-efficacy for pain management will mediate response for subjects randomized to venlafaxine xr and PST-DP.


Not applicable.


The results of this trial will inform the care of these complex patients and further understanding of comorbid pain and depression in late life.

Wiley Periodicals, Inc.

[PubMed - indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Blackwell Publishing Icon for PubMed Central
    Loading ...
    Write to the Help Desk