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Cited by 104Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Efficacy and tolerability of antidepressants in people aged 65 years or older with major depressive disorder – A systematic review and a meta-analysis

Tham, Anne, Jonsson, Ulf, Andersson, Gerhard, Söderlund, Anne, Allard, Per, Bertilsson, Göran·2016·Journal of Affective Disorders
DOI 10.1016/j.jad.2016.06.013
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Abstract

Background There has been a steady increase in the prescription of antidepressants for the elderly. This study comprises a systematic review of randomized, placebo-controlled trials of antidepressants for treatment of depressive disorder in people aged 65 years or more.Methods PubMed, EMBASE, Cochrane Library, CINAL, and PsycINFO were searched until May 2016. Where appropriate, the results were synthesized in meta-analyses.Results Twelve trials met the inclusion criteria. For patients with major depressive disorder, selective serotonin re-uptake inhibitors (SSRI) were not superior to placebo in achieving remission (OR: 0.79, 95% CI: 0.61-1.03) or response (OR=0.86, 95% CI: 0.51-1.10) after 8 weeks of treatment (three trials). However, maintenance treatment with SSRIs was superior to placebo in preventing relapse (OR: 0.22, 95% CI: 0.13-0.36; NNT=5, 95% CI: 3-6; two trials). Duloxetine was superior to placebo in achieving remission (OR: 1.78, 95% CI: 1.20-2.65; NNT=9, 95% CI: 6-20; three trials) and response (OR: 1.83, 95% CI: 1.96-4.08; two trials) in recurrent major depression after 8 weeks, but increased the risk of adverse events that can be problematic in the elderly.Limitations The quality of evidence was generally low or moderate, emphasizing the uncertainty of the results. Study populations only partly covered the heterogeneous population of elderly with depressed mood, limiting the generalizability.Conclusion The results underscore the importance of close monitoring of the effects of antidepressants in treatment of elderly patients with a depressive disorder. Methods for early detection of non-responders and effective treatment options for this group are needed.

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Authors
Tham, A., Jonsson, U., Andersson, G., Söderlund, A., Allard, P., & Bertilsson, G.
Affiliations
  • Karolinska Institutet (SE)
  • Uppsala University (SE)
  • Linköping University (SE)
  • Mälardalen University (SE)
  • SBU - Swedish Agency for Health Technology Assessment and Assessment of Social Services (SE)
Corresponding author
Bertilsson, Göran
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2016-11
Volume
205
Pages
1-12
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2016.06.013
OpenAlex
W2434444698
Cited by
104
References
60
Citations by year
2026: 4 · 2025: 12 · 2024: 8 · 2023: 14 · 2022: 15 · 2021: 15 · 2020: 6 · 2019: 14 · 2018: 6 · 2017: 9 · 2016: 1
FWCI
1.14
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
Funders
Swedish Agency for Health Technology Assessment and Assessment of Social Services
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
antidepressants, major depressive disorder, older adults, selective serotonin reuptake inhibitors, duloxetine, remission, treatment response, relapse prevention, maintenance therapy, adverse events, tolerability, antidepressant efficacy
MeSH terms
Duloxetine Hydrochloride, Aged, Antidepressive Agents, Major Depressive Disorder, Humans, Odds Ratio, Treatment Outcome, Selective Serotonin Reuptake Inhibitors

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