Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder
Open accessAbstract
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 10 mg/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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Treatment responders for depression are more likely to have better social support at baseline than nonresponders.
“and treatment responders for depression are more likely to have better social support at baseline than nonresponders.26,27”
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- Authors
- Saghafi, R., Brown, C., Butters, M. A., Cyranowski, J., Dew, M. A., Frank, E., Gildengers, A., Karp, J. F., Lenze, E. J., Lotrich, F., Martire, L., Mazumdar, S., Miller, M. D., Mulsant, B. H., Weber, E., Whyte, E., Morse, J., Stack, J., Houck, P. R., Bensasi, S., & Reynolds, C. F.
- Affiliations
- University of Pittsburgh (US)
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- Reynolds, Charles F.
- ORCID
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2007-05-08
- Volume
- 22
- Issue
- 11
- Pages
- 1141-1146
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- PMC
- PMC3579589
- OpenAlex
- W2098221822
- Cited by
- 47
- References
- 37
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 2 · 2015: 3 · 2014: 2 · 2013: 5 · 2012: 2
- FWCI
- 4.90
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000005, KL2TR000146)
- National Institute of Mental Health (R01 MH 43832, R01 MH37869, P30MH071944, T32 MH19986, R01MH037869, R01MH043832, T32MH019986)
- National Center for Advancing Translational Sciences
- National Institute on Minority Health and Health Disparities (P60MD000207)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- escitalopram, antidepressant response, treatment non-response, predictors of treatment response, anxiety symptoms, self-esteem, depression severity, older adults, hopelessness
- MeSH terms
- Aged, Anxiety, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Prognosis, Psychiatric Status Rating Scales, Quality of Life, Self Concept, Social Support, Citalopram, Geriatric Assessment, Treatment Outcome, Antidepressive Agents, Second-Generation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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