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J Affect Disord. 2019 May 15;251:136-140. doi: 10.1016/j.jad.2019.03.057. Epub 2019 Mar 20.

Treatment response of lithium augmentation in geriatric compared to non-geriatric patients with treatment-resistant depression.

Author information

1
Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Campus Neuruppin, 16816 Germany; Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Germany. Electronic address: pichit.buspavanich@charite.de.
2
Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Campus Neuruppin, 16816 Germany; Research Department of Experimental and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Germany.
3
Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Campus Neuruppin, 16816 Germany; Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Germany.
4
Department of Statistics, Informatics and Documentation, Jena University Hospital, Germany.
5
Department of Psychiatry and Psychotherapy, Technical University of Dresden Medical School, Dresden, Germany; Department of Psychiatry, Schlosspark-Klinik Berlin, Germany.
6
Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Germany; Department of Psychiatry and Psychotherapy, Vivantes Klinikum Kaulsdorf, Berlin, Germany.
7
Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Germany.
8
Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Campus Neuruppin, 16816 Germany.
9
Department of Psychiatry, Vivantes Wenckebach-Klinikum Berlin, Germany.
10
Department of Psychiatry, Oberhavel Kliniken, Henningsdorf, Germany.
11
Department of Psychiatry, Vivantes Humboldt-Klinikum Berlin, Germany.
12
Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Germany; Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Germany.

Abstract

BACKGROUND:

Lithium augmentation (LA) of antidepressants is an effective strategy for treatment-resistant depression (TRD). Nevertheless, it is rarely used in geriatric patients. The purpose of this study was to investigate treatment response of LA in geriatric compared to non-geriatric patients.

METHOD:

In a prospective multicenter cohort study, severity of depression was measured weekly in 167 patients with unipolar depression (nage≥65years = 22; nage<65years = 145) at baseline and over at least four weeks of LA.

RESULTS:

Geriatric patients showed a significantly better response to LA compared to non-geriatric patients (Hazard Ratio = 1.91; p = 0.04).

LIMITATIONS:

An important limitation of our study is the lack of a control group of LA and the missing evaluation of side effects in both groups.

CONCLUSIONS:

This is the first study investigating the efficacy of LA for TRD in geriatric compared to non-geriatric patients. Our data suggest that LA is an effective treatment option in geriatric patients that clinicians might consider more frequently and earlier on in the course of treatment.

KEYWORDS:

Efficacy; Geriatric patients; Lithium augmentation; Treatment-resistant depression

PMID:
30921597
DOI:
10.1016/j.jad.2019.03.057

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